This article, titled “Defining and Implementing Value-Based Health Care: A Strategic Framework“, authored by Elizabeth Teisberg, Scott Wallace, and Sarah O’Hara, provides a comprehensive overview and strategic framework for implementing value-based healthcare. Published in Academic Medicine in 2020, the paper addresses the critical need to improve patient health outcomes relative to the cost of care.
The authors define value in health care as the measured improvement in a patient’s health outcomes for the cost of achieving that improvement. They clarify that value-based healthcare is often confused with cost reduction, quality improvement, or patient satisfaction, but these are distinct concepts. While cost reduction is important, it is not sufficient on its own, as true value is created only when health outcomes improve. Similarly, quality improvement efforts may not always translate to better patient outcomes, and patient satisfaction, though emphasizing dignity and respect, differs from the core purpose of improving health. The essential focus of value-based healthcare is improving patient health outcomes.
The article highlights that improving value aligns the goals of various healthcare stakeholders, including patients, providers, health plans, employers, and government organizations. It emphasizes focusing on outcomes that matter most to patients, described in terms of capability, comfort, and calm. Capability refers to a patient’s ability to engage in activities that define them; comfort involves relief from physical and emotional suffering; and calm signifies the ability to live normally while receiving care, free from systemic chaos.
The paper introduces a strategic framework for implementation, derived from over a decade of research into organizations that have successfully achieved better outcomes, often at lower costs. This framework involves:
- Identifying and understanding a segment of patients with consistent health needs.
- Designing and delivering comprehensive solutions to address these needs through interdisciplinary teams.
- Measuring the health outcomes and costs of care for each patient to drive ongoing improvements.
- Expanding partnerships as evidence of improved care creates opportunities to serve more patients.
Furthermore, the authors suggest that medical schools, like The University of Texas at Austin’s Dell Medical School, should incorporate education on the principles and implementation of value-based health care throughout their curricula to prepare future physicians for this transformation. The article underscores that value-based healthcare helps reconnect clinicians to their purpose as healers, supports professionalism, and can act as a powerful counter to clinician burnout by focusing on meaningful results for patients. Better outcomes also lead to reduced spending and decreased need for ongoing care in the long term.
Reference: Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and implementing value-based health care: A strategic framework. Academic Medicine, 95(5), 682–685. https://doi.org/10.1097/ACM.0000000000003122
