Value-based Learning Healthcare Systems: Integrative Modeling and Simulation

Abstract

Achieving value-based healthcare - increasing quality, reducing cost, and spreading access - has proven to be extremely challenging, in part due to research that is siloed and largely focused on singular risk factors, ineffective care coordination resulting from service fragmentation, and costly unintended consequences of reform that have emerged due to the complexity of healthcare systems. Understanding the behavior of the overall system is becoming a major concern among healthcare managers and decision-makers intent on increasing value for their systems. This book fills a gap in the literature that is becoming more evident as reform efforts proliferate: a holistic Modeling and Simulation (M&S) approach to value-based healthcare within a framework that enables designing, testing and implementing concepts to integrate resource allocations, health phenomenon dynamics, individual behavior, and population dynamics. It presents a pathways-based efficient coordination of care model involving all stakeholders including patients, providers, care deliverers, managers, and payers. It shows how M&S can help design a better service infrastructure and describes the information technologies that are necessary to implement it successfully. It also presents global and national healthcare perspectives from Europe, USA, Asia and Africa, as well as research directions needed to realize the value-based M&S healthcare vision.