The road to value-based healthcare

In a world characterised by an ageing population and increasing costs, improving healthcare value by delivering better health outcomes to patients at lower costs has become a critical imperative.

By Deepa Narwani, Editor

A recent trend in healthcare has been the increasing shift to a value-based model that is focused on improving the quality of patient outcomes, while enhancing care and implementing initiatives that control costs.

A recent report titled ‘Value in Healthcare: Accelerating the Pace of Health System Transformation’ by World Economic Forum, in collaboration with the Boston Consulting Group (BCG), highlighted that in a world characterised by an ageing population, and with more people suffering from long-term chronic disease, and increasing costs, improving healthcare value by delivering better health outcomes to patients at lower costs has become a critical imperative.  

In an interview with Arab Health Magazine, Jad Bitar, Partner and Managing Director at BCG shared: “Today, we are starting to move away from strictly curative and preventative models to value-based healthcare.

“It is not only about minimising mortality and keeping you healthy, but about ensuring top outcomes not only as science or the clinicians decide but also factoring in what is important to the patient, and to the least cost possible.

“For instance, I can have a million-dollar treatment for cancer and might save five per cent. But the question is that, am I, with this additional dollar able to have an impact on the most number of people the way they want? Some individuals with cancer would prefer to go into palliative care at home and die peacefully. The opinion of the patient is paramount when you are measuring value; it’s not only a clinical perspective that we need to save people at any cost. This is a new concept, which has been around for the last few years.”

Bitar explained that what value-based healthcare brings to the table is a major challenge to clinicians and managers in the healthcare system. It is telling them that the way they have been operating is good, but it can be improved. Clinicians have been focused on treating diseases, but now they need to step back and think about the humans in front of them and engage with them.  

The report defined value as the health outcomes achieved for defined population segments (for example, all individuals suffering from a particular disease or belonging to a specific risk group) for a given cost. It explained that value-based health system’s goal is to improve outcomes and reduce costs through the provision of improved, segment-specific clinical interventions.

He said: “The clinician is no longer the unique pilot, they are co-designing, and we have seen this in the last 10 years. This is known as consumerism in healthcare where patients are becoming more and more involved in defining what they want. Today, physicians need to be ready to engage in a dialogue, and it is one of the important components of value-based healthcare.”

The second factor of consideration is for the manager. According to Bitar, they have been focusing on the wrong KPIs, such as how many doctors they have, how many beds and MRI machines they have, etc. The managers tend to focus on, for instance, if the average length of stay has been reduced, but value-based healthcare says that the focus should be on outcomes.

Bitar gave the example of prostate cancer. The factors for consideration should not only be the mortality rate and how many patients survived the procedure, but other factors important to the patient such as the incontinence rate as well; after the treatment, were they able to have a quality life. It’s not only about saving lives, it’s more than that.

Jad Bitar

The focus of value-based healthcare is more on quality of life. When you talk about value it is not just in financial terms, but to highlight the value for all the stakeholders – for the system and clinician but for the patient too. However, it is not only about the value and benefits created, but also the cost at which the clinicians and the management are able to deliver this benefit.

According to the report, one critical enabler of value-based healthcare is health informatics – information technology software and systems, as well as methodologies for the collection, management, use and analysis of health data. The report calls for a comprehensive agenda for accelerating the development of global health informatics standards. This agenda includes a call to action for the creation of a “digital health bill of rights” that puts patient empowerment at the centre of informatics standardisation efforts. It also defines approaches for assessing current standardisation initiatives, endorsing emerging standards, developing new use-cases and publishing guidelines for the implementation and adoption of global informatics standards.

He concluded: “In the last few years since the value-based healthcare model has been adopted, we are seeing some very interesting experiments all over the world."

 

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