Value-Based Healthcare Concept Research Articles

Innovation Pipeline: A framework for value-based decision making.

The concept of value-based healthcare and focus on health outcomes is not new. While these ideas have been shared for decades, health systems still struggle to implement value-based decision making. This article describes the Innovation Pipeline, a framework that embeds value-based decision making in a healthcare organization. The Innovation Pipeline outlines the measurable evidence requirements needed to demonstrate organizational definitions of value. This evidence of value allows health leaders to make decisions supported by rigorous data, evidence, and evaluation, ensuring initiatives that bring organizational value progress from good ideas that require testing to evidence-based services embedded and sustained in operational workflows. The Innovation Pipeline is rigorous and customizable to all levels of the health system and designed to streamline evidence-generation activities, focusing on collecting evidence needed to demonstrate value and inform funding and resource allocation decisions.

Challenges And Solutions in Rare Disease Treatment: Value-Based Healthcare

This study is based on the realities of challenges within the field of rare disease treatment, as well as the concept of value-based healthcare. By analyzing treatment plans, rehabilitative care, cost-sharing, prospects for drug development markets and investment returns, as well as policy support, the paper delves into the complexities and diversities of rare disease treatment. Within the research, the focus is on the challenges of rare disease treatment, leveraging the principles of value-based healthcare. It discusses how personalized treatment plans, interdisciplinary collaboration, and reasonable cost-sharing can enhance patient treatment outcomes and quality of life. The article employs methods such as literature reviews and case analyses to deeply explore and analyze rare disease treatment from various angles. The research findings indicate that personalized treatment plans and interdisciplinary collaboration can significantly enhance treatment outcomes and quality of life for rare disease patients. Reasonable cost-sharing models and trends in drug development markets present opportunities for the sustainable growth of the rare disease field. Additionally, policy support and international cooperation mechanisms play vital roles in advancing rare disease treatment. Based on these research findings, the article proposes future research prospects, including strengthening data collection and analysis, deepening international collaboration, and optimizing drug development strategies.

A Social Network Analysis of Influences on Residents' Value-Based Decisions.

To ensure a value-based health care system, it is becoming increasingly important that residents are trained in making value-based decisions. This study explored the social network influencing residents' value-based decisions. To explore the social network influencing residents' value-based decisions, the authors used a semistructured individual and mini-group interviewing approach and participatory visual mapping. In total, 17 residents across 13 different specialties were interviewed from the southeastern postgraduate medical education and training region of the Netherlands, May-November 2021. Two researchers independently coded the transcribed data using an integrated inductive thematic approach. Subsequently, social network analysis was used to visualize the results. Residents indicated that their value-based decisions were influenced by direct actors who influenced decisions related to patients and indirect actors who shaped decisions related to patients without directly modifying them. Different interaction-aspects (i.e., personal, situational, and institutional) further affected residents' ability to make value-based decisions. Thus, residents' value-based decisions were a product of the interplay between various interactions with actors and different interaction-aspects. Residents defined value-based decisions differently, even within an interview. These results suggest residents' value-based decisions are influenced by a multitude of actors, including hierarchically superior colleagues who can directly alter decisions and patients (and their families) and nurses with whom residents consider it important to maintain good relationships. In addition, more experienced actors, mainly from the medical and nursing profession, contribute most to learning. Furthermore, residents' value-based decisions are deeply underpinned by the hidden curriculum. However, many senior physicians may not have received sufficient training in the concept of value-based health care. Consequently, an approach of formally educating residents in value-based health care will likely have limited effects unless social influences in day-to-day clinical settings reinforce its importance.

Opportunities and Challenges to the Implementation of Value-Based Healthcare (VBHC) in SMES: The Case of the State of Qatar

Abstract The purpose of this paper is to identify the opportunities and barriers to the implementation of VBHC in SMEs in Qatar. A semi-structured survey was developed to investigate the perspectives of healthcare providers, from SMEs of public and private sectors, on the opportunities and barriers to the adoption of VBHC in Qatar. The respondents include government officials, CEOs, middle managers, first-line managers, and physicians. Twenty-four out of forty respondents responded. The collected data was aggregated and analyzed. Interestingly, the aggregated information is similar in content to some other countries. Examples of main opportunities include ease of implementation, focus being on outcomes that matter to patients and fosterage of integration and collaboration between public and private sectors. The key barriers/challenges include need for standardized communications and technological infrastructure, and conflicting interests of public and private sectors. The concept of VBHC was first introduced in the United States of America (USA) in 2006 to drive the move from fee-for-service (FFS) approach to fee-for-value (FFV) model. Nonetheless, the debate on the effectiveness of this transformation continues. Although the current emphasis on VBHC may offer new opportunities, barriers are also anticipated. Furthermore, the published evidence on this phenomenon is still limited.

Value-Based Healthcare: Is It Just Another Buzzword?

The concept of value-based healthcare has been gaining traction, with several issues of Healthcare Policy discussing the agenda and highlighting pockets of excellence. However, we currently have no shared common goal that would define value-based healthcare. Furthermore, we have major limitations in measuring both the cost and benefit components of the concept of value, irrespective of the definition. It is time to make progress, which will include a recognition of the need to engage the public in a discussion around the values of the Canadian healthcare system and the federal government taking a hands-on role for the accountability of value as an outcome.

Value-Based Healthcare and Radiology: How can Value be Measured?

The concept of value-based healthcare (VBH) emerges as a response to traditional models of healthcare system management. More specifically, in radiology, the transition from volume to value has been discussed by its main associations, having as the main concern regarding the role of the specialty in a more integrated healthcare context. Through a qualitative study, this work aims to analyse and evaluate how this new concept can be implemented in radiology by identifying obstacles and mapping the technical and procedural improvements necessary for its correct implementation in the national context of healthcare provision. Through interviews with different elements of the healthcare sector (from doctors to industry partners and researchers), it was possible to draw a set of metrics for measuring the value of radiology, alongside the implementation of a VBH strategy. As the main conclusion, the implementation of a strategic agenda for the creation of value in radiology at the national level should be based on the reduction of variability and the identification of best practices in terms of adequacy, quality, safety and efficiency, aiming to satisfy the needs of requesting doctors and patients.

Key Success in The Transformation from Volume-Based to Value-Based Healthcare: A Scoping Review

The medical cost trend had been increasing faster than the global inflation rate. Higher costs posed a significant problem for healthcare providers, payers, and eventually patients. The concept of value-based healthcare (VBHC), which emphasized the importance of measuring outcomes relative to the costs, was introduced to mitigate the impact of these medical trends. This research used a scoping review methodology to describe the factors that affect the shift from the conventional volume-based healthcare to value-based healthcare. Data of research based on article search was conducted using online Scopus and Embase databases, resulting in 800 articles describing value-based healthcare. Duplication removal excluded 76 articles, screening excluded 295 articles, eligibility assessment excluded 76 articles, and the remaining 30 articles were included. The results of study show that VBHC was proposed as a shift in healthcare management entailing six reinforcing elements, but most hospitals have implemented only one VBHC element. The most common implemented elements are “the measurement of outcome and cost” and “the reorganization to integrated practice units.” The key success for the implementation of these elements are: (1) strong data collection to measure clinical outcomes that matter to patients, (2) clear governance of this data management, and (3) strong support from the high leadership to encourage multidisciplinary teamwork. Thus, the true VBHC system can only be reached when all the six elements are achieved. However, no single study describes a success in implementing all elements of VBHC. Hospital leaders need to be cautious when interpreting VBHC as not to think that the VBHC can be reached by cherry-picking only selected elements of VBHC.

Translating to Maintain Existing Practices: Micro-tactics in the implementation of a new management concept

Research has demonstrated how the translation of a new management concept into organizational practices is impacted by the translators’ engagement with their local context. We expand this literature by demonstrating how a heterogeneous institutional context prompts translators to create practice change and also practice maintenance. Building upon an interpretive analytical framework we offer a way forward to examine relationships between societal institutions and distributed collective work in change processes. Our longitudinal qualitative study based upon interviews and observations examines how the concept of value-based healthcare was translated at a hospital. The translators developed three micro-tactics: disregard, maintenance and displacement, grounded in their narration of practice changes. Translators enacted institutional logics differently at the levels of meaning and practice when they framed, rationalized and contextualized the potentialities of a new concept, and this complexity provided the possibility of various practice outcomes. We contribute to the understanding of translation by demonstrating how a heterogeneous institutional context encourages translators to change selected practices but also to decouple and maintain most of the existing practices due to their enactment of institutionalized rationalities. Moreover, we discuss how translation outcomes are impacted by collaborating actors’ shared interpretations of their institutional context. Collaborating translators need to agree on whether and what practice change is valuable for the organization, and change is only possible when they interpret that they have the leverage to align a new idea with dominant institutional logics.

Value-based primary care in Australia: how far have we travelled?

Summary In this article, we discuss how the value‐based health care concept has matured across recent years, and consider how it can be achieved in the primary health care sector.We provide illustrations of related initiatives across the four domains of value‐based health care, highlight the need for cultural transformation and reorientation of the system, and call for a national framework and agreed plan of action.

Organizing Value-based Product Innovation: How Medical Equipment Manufacturers Embrace Complexity in Hybrid Operating Rooms

This article shares research findings from the healthcare equipment manufacturing industry on how product management teams can enhance their value-based innovation processes. Value-based healthcare (VBHC) has transformed healthcare systems worldwide by shifting their focus towards patient-centred value creation. The VBHC concept has also inspired medical equipment manufacturers that seek to enable healthcare providers to realize their VBHC ambitions. In this article, we focus on the development of hybrid solutions for operating rooms in the context of VBHC. Hybrid operating rooms (HORs) add real-time medical imaging to surgical and interventional treatment of patients. This combination is quite challenging to realize, not just in terms of technology but also organizationally. Adjusting technology to the requirements of multiple clinical stakeholders drives complexity to unprecedented heights. How can product strategists manage this multi-stakeholder complexity? Through in-depth case research, we found that adopting a clear VBHC vision is key for product management teams designing HOR innovations. A VBHC vision allows multiple teams to align and effectively collaborate with the goal of enhancing patient care. In addition, we found that integrating inside-out and outside-in perspectives on product innovation helps medical equipment manufacturers produce VBHC-compatible innovations and foster collaboration between clinicians working in multipurpose rooms such as HORs.

Broadening the concept of patient safety culture through value-based healthcare

PurposeDecision-makers are looking for innovative approaches to improve patient experience and outcomes with the finite resources available in healthcare. The concept of value-based healthcare has been proposed as one such approach. Since unsafe care hinders patient experience and contributes to waste, the purpose of this paper is to investigate how the value-based approach can help broaden the existing concept of patient safety culture and thus, improve patient safety and healthcare value.Design/methodology/approachIn the arguments, the authors use the triple value model which consists of personal, technical and allocative value. These three aspects together promote healthcare in which the experience of care is improved through the involvement of patients, while also considering the optimal utilisation and allocation of finite healthcare resources.FindingsWhile the idea that patient involvement should be integrated into patient safety culture has already been suggested, there is a lack of emphasis that economic considerations can play an important role as well. Patient safety should be perceived as an investment, thus, relevant questions need to be addressed such as how much resources should be invested into patient safety, how the finite resources should be allocated to maximise health benefits at a population level and how resources should be utilised to get the best cost-benefit ratio.Originality/valueThus far, both the importance of patient safety culture and value-based healthcare have been advocated; this paper emphasizes the need to consider these two approaches together.

Redefining value in post-COVID-19 healthcare: A perspective

As the world continues its fight against the COVID-19 pandemic, one wonders how healthcare will change after the dust settles. In recent years, the concept of value-based healthcare has emerged as healthcare payers and providers attempt to deliver good health outcomes at optimal costs. But as the pandemic has demonstrated, is value in healthcare simply about balancing bedside care quality and cost? There is a need to go beyond this myopic perspective of value and consider how the global reaction to COVID-19 will change stakeholders’ expectations of future healthcare, its delivery and the extent to which society is prepared to invest or trade off to prevent future such crises. This paper discusses new value norms which will emerge, post-pandemic, which go beyond the quality-cost equilibrium, as the definitions of quality and cost are redefined in the context of wider public health and its impact on society.

Value Based Healthcare. A Strategy for the Cost and Clinically Effective Healthcare System Operation

Purpose: The submitted article focuses on how to solve the problems faced by the European healthcare systems. Design/Methodology: The article consists of two sections. The first one is theoretical and presents interdisciplinary achievements of researchers. The second section includes examples of solutions applied in Sweden, Germany and Great Britain. In the theoretical part, books and articles on the methodology of VBHC creation were reviewed. The empirical part is based on reports on the introduction of VBHC. Findings: The desire to improve cost and clinical effectiveness indicates the need for a value-based healthcare (VBHC). Thus, the concept of VBHC should contribute, according to experts, economists as well as finance and management specialists, to the economic efficiency and clinical effectiveness. Research limitations/implications: Unfortunately, this is a lengthy process to be preceded by many activities. Healthcare registers and databases belong to the most important ones. Thanks to them, it is possible to create the key performance indicators (KPI) allowing for a rational health policy. Original value: To the achievements contained in the publications, the submitted article adds the need to take into account appropriately selected KPIs analyzing the macroeconomic environment for the functioning of hospitals.

Value-Based Health Care in the Pediatric Emergency Department

Value-based health care is finding increasing importance in medical care. This manuscript reviews the concept of value-based health care and its application to pediatric patients with cardiac complaints in the emergency department.

Value-based surgical care: a view from the surgeon's knife.

NHS trusts across the country are facing unprecedented financial pressures, along with rising levels of demand and widespread variation in surgical quality and cost. There is a moral and financial imperative to provide the most efficient use of resources in order to ensure sustainability of a system that is free at the point of use, and provide consistently high-value care for patients across the country. Delivering 'value' does not mean any reduction in the quality of care - it means achieving the same or higher quality at the same or lower cost. Avoidable and costly incidents in surgery occur every day: patients do not receive the right care, procedures or tests are performed without real benefit, complications lead to prolonged hospital stays, to readmissions and re-interventions. Put simply: poor quality surgical care is expensive. The concept of value-based health care is well known in the UK, yet its principles are not yet fully embedded in the health-care system, surgical training or practice. The shift towards better value-based care with a focus on delivery system reform (Getting It Right First Time), outcomes-based commissioning and payment reform (accountable care systems and integrated care systems) provides an opportunity to make significant improvements in surgical care. Radical and immediate change is required, and everyone, from trainees at the frontline, to clinical leaders, trust chief executives, local commissioners and policy-makers, has vital roles to play. The health-care system needs to be designed, organized and paid for differently to deliver better surgical value for patients.

Redefining Health: Implication for Value-Based Healthcare Reform.

Health definition consists of three domains namely, physical, mental, and social health that should be prioritized in delivering healthcare. The emergence of chronic diseases in aging populations has been a barrier to the realization of a healthier society. The value-based healthcare concept seems in line with the true health objective: increasing value. Value is created from health outcomes which matter to patients relative to the cost of achieving those outcomes. The health outcomes should include all domains of health in a full cycle of care. To implement value-based healthcare, transformations need to be done by both health providers and patients: establishing true health outcomes, strengthening primary care, building integrated health systems, implementing appropriate health payment schemes that promote value and reduce moral hazards, enabling health information technology, and creating a policy that fits well with a community.

Experiences from implementing value-based healthcare at a Swedish University Hospital \u2013 a longitudinal interview study

BackgroundImplementing the value-based healthcare concept (VBHC) is a growing management trend in Swedish healthcare organizations. The aim of this study is to explore how representatives of four pilot project teams experienced implementing VBHC in a large Swedish University Hospital over a period of 2 years. The project teams started their work in October 2013.MethodsAn explorative and qualitative design was used, with interviews as the data collection method. All the participants in the four pilot project teams were individually interviewed three times, with interviews starting in March 2014 and ending in November 2015. All the interviews were transcribed and analyzed using qualitative analysis.ResultsValue for the patients was experienced as the fundamental drive for implementing VBHC. However, multiple understandings of what value for patients’ means existed in parallel. The teams received guidance from consultants during the first 3 months. There were pros and cons to the consultant’s guidance. This period included intensive work identifying outcome measurements based on patients’ and professionals’ perspectives, with less interest devoted to measuring costs. The implementation process, which both gave and took energy, developed over time and included interventions. In due course it provided insights to the teams about the complexity of healthcare. The necessity of coordination, cooperation and working together inter-departmentally was critical.ConclusionsHealthcare organizations implementing VBHC will benefit from emphasizing value for patients, in line with the intrinsic drive in healthcare, as well as managing the process of implementation on the basis of understanding the complexities of healthcare. Paying attention to the patients’ voice is a most important concern and is also a key towards increased engagement from physicians and care providers for improvement work.

PHP51 - Early Benefit Assessment Of Drugs And The Value-Based Healthcare Concept – A Qualitative Inquiry Within The Pharmaceutical Industry

PHP51 - Early Benefit Assessment Of Drugs And The Value-Based Healthcare Concept – A Qualitative Inquiry Within The Pharmaceutical Industry

A Microcosting Approach for Isolated, Unilateral Cleft Lip Care in the First Year of Life

The concept of value-based health care underlies many new improvement initiatives in U.S. health care. To determine value, accurate measures of both outcomes and costs are essential, which may then be compared for the same provider or system over time or between providers, to foster improvement. Although outcomes measurement has received a great deal of attention since the quality movement began in the United States, costing methodologies are lacking. A basic microcosting methodology was used to obtain direct medical costs, including physician compensation, for individuals with isolated, unilateral cleft lip deformity receiving their full course of care from one surgeon. The authors analyzed costs associated with the timeline of care during the first year of life. The median cost for the first year of life was $13,013 (range, $10,426 to $16,115; n = 12). Ninety-one percent of costs were associated with the cleft lip repair, which occurred at a median age of 3.7 months. The majority of these costs stemmed from time in the operating room and the inpatient stay, which accounted for 68 and 19 percent of first-year costs, respectively. Using a microcosting approach, the authors identified specific cost drivers and outlined a distinct timeline of care for patients with isolated cleft lip in the first year of life. This approach may serve as a template for the cost side of the value equation, for which accurate methodologies are needed. When combined with key outcomes measures, it will be possible to measure and improve value at the patient and provider levels.