How To Successfully Implement Value-Based Healthcare

This article draws insights from Dr. Michael Shenouda, CCO at Open Medical, following conversations with clinicians, executives, subject matter experts, academia, and government leads across seven countries and three continents.

Image created by Rudy Chidiac. © Open Medical 2024. All Rights Reserved

Value-based healthcare was introduced nearly two decades ago. Although there are sporadic examples of successful implementation, few instances demonstrate successful implementation on a large scale. 

Three recurring themes have been identified that can enhance the implementation of value-based healthcare.

1. Education, especially for the clinical workforce

Despite extensive academic research on value-based care, these concepts need to be put into practice. This involves choosing appropriate outcome measures, understanding the validation process, and timing, among other nuances.

It is crucial to disseminate this knowledge, especially at the clinical level, to help the workforce comprehend the true essence of value-based care. Without the clinical bodies' endorsement, practical implementation will remain a challenge.

2. Consideration of patient complexity in healthcare models

Clinicians often express concerns about handling complex cases involving patients with multiple co-morbidities or previous surgeries, which may limit the possibility of significant improvements in patient outcomes.

However, even minor improvements can significantly benefit such patients and society at large, making these cases equally important. Therefore, the complexity of these cases must be incorporated into value-based care delivery and payment models.

3. Integration into processes

Value-based care needs to be woven into the clinical workflow to minimise overhead and, more importantly, secure patient buy-in.

This approach must become a standard practice, requiring patient cooperation. Therefore, education plays a pivotal role once again. Patients need to understand the purpose of Patient-Reported Outcome Measures (PROMs), why they are necessary, and what they measure. Patients should be informed that their hospital stay's quality, including factors like food and staff, is separate from their surgical procedure's clinical outcomes.

By focusing on these three themes—education, patient complexity, and process integration—healthcare providers and organisations can implement value-based healthcare on a larger scale.