Summary D026 Implementing value-based care| action
plan Dina Jones WESTERN GOVERNERS UNIVERSITY
Value based health care - ANSWER: The optimal balance bewtween the gain in
health, costs & societal value, considering characteristics of the individual patient
Big changes that allow us to change health care - ANSWER: - electronic patient file
- ICT
- PROM's
- PREM's
- (public) databases
How is value measured? - ANSWER: - medical outcome (survival + recovery)
- PROM's
- Societal outcome (return to work)
Why is VBHC hard to implement - ANSWER: - cultural change: doctors broader view +
willingness + patient must be ready
- Logistics: right questionnaire on right time
- ICT:
Value Chain - ANSWER: all activities that a business organization performs, which
together create a valuable product or service
central premise VBHC - porter - ANSWER: In any industry, a successful and
sustainable enterprise needs to create value for its clients - particularly in a
competitive market
What does creating value for your clients mean for the health care? (Porter) -
ANSWER: - value as the single goal
- clients = patients
- goal = patient value
value - ANSWER: Outcomes / costs
What do patients value? - ANSWER: The health status they achieve (outcomes) and
the price they must pay for it (costs)
The best outcomes, as efficiently as possible
Key principle value creation - ANSWER: Value in health care is created at the level of
medical conditions, over the full cycle of care
Level of medical conditions - ANSWER: Patients seek health care to address health
related issues—> those issues are caused by a certain condition—> ergo:
professionals create value by addressing specific conditions (diagnosing)
, Full cycle of care - ANSWER: From diagnosing to rehabilitation. In this full cycle, value
is created.
Also needs to be measured over the full cycle! (Costs & outcomes)
Measuring & reporting outcomes is crucial for... - ANSWER: Effective comparisons
integrated practice units - ANSWER: Multidisciplinary team, all working in 1 location,
coordinating all the services necessary to address a medical condition
Full cycle of care can be used for... - ANSWER: - measurement
- organizing care delivery
- payment
Value Based Payment - ANSWER: Bundelen payments that cover full cycle of care. So
1 bill for the patient.
For chronic conditions: bundelend payments over episodes of care
Consequences value based payment - ANSWER: - removing adverse incentives ( over
treatment by fee-for-service)
- rewarding good outcomes and efficiency ( with more patients or financial bonus
(pay-for-performance))
Value-Based Competition - ANSWER: excellent providers receive more patients and
the patients benefit from excellent care.
Provider that can't keep up should restructure or go out of business
Isssue with Dutch health care - ANSWER: - fragmented
- pay incentivizes volume ipv value
- measure with process indicators ipv outcome indicators
- need to be a balance between measuring for accountability and measuring for
improvement
- need for orchestrated teams that take responsibility for full cycle of care
What patients value - ANSWER: - patient level: uniqueness + autonomy
- interaction level: partnership + empowerment
- professional level: compassion + professionalism + responsiveness
Porters three tiers - ANSWER: 1: health status achieved/retained + survival rate
2: recovery time + time to remission
3: sustainability of health/recovery + disease recurrence
PREM's - ANSWER: Patient reported experience measures:
Patient satisfaction; doctor takes me seriously, listened carefully etc
plan Dina Jones WESTERN GOVERNERS UNIVERSITY
Value based health care - ANSWER: The optimal balance bewtween the gain in
health, costs & societal value, considering characteristics of the individual patient
Big changes that allow us to change health care - ANSWER: - electronic patient file
- ICT
- PROM's
- PREM's
- (public) databases
How is value measured? - ANSWER: - medical outcome (survival + recovery)
- PROM's
- Societal outcome (return to work)
Why is VBHC hard to implement - ANSWER: - cultural change: doctors broader view +
willingness + patient must be ready
- Logistics: right questionnaire on right time
- ICT:
Value Chain - ANSWER: all activities that a business organization performs, which
together create a valuable product or service
central premise VBHC - porter - ANSWER: In any industry, a successful and
sustainable enterprise needs to create value for its clients - particularly in a
competitive market
What does creating value for your clients mean for the health care? (Porter) -
ANSWER: - value as the single goal
- clients = patients
- goal = patient value
value - ANSWER: Outcomes / costs
What do patients value? - ANSWER: The health status they achieve (outcomes) and
the price they must pay for it (costs)
The best outcomes, as efficiently as possible
Key principle value creation - ANSWER: Value in health care is created at the level of
medical conditions, over the full cycle of care
Level of medical conditions - ANSWER: Patients seek health care to address health
related issues—> those issues are caused by a certain condition—> ergo:
professionals create value by addressing specific conditions (diagnosing)
, Full cycle of care - ANSWER: From diagnosing to rehabilitation. In this full cycle, value
is created.
Also needs to be measured over the full cycle! (Costs & outcomes)
Measuring & reporting outcomes is crucial for... - ANSWER: Effective comparisons
integrated practice units - ANSWER: Multidisciplinary team, all working in 1 location,
coordinating all the services necessary to address a medical condition
Full cycle of care can be used for... - ANSWER: - measurement
- organizing care delivery
- payment
Value Based Payment - ANSWER: Bundelen payments that cover full cycle of care. So
1 bill for the patient.
For chronic conditions: bundelend payments over episodes of care
Consequences value based payment - ANSWER: - removing adverse incentives ( over
treatment by fee-for-service)
- rewarding good outcomes and efficiency ( with more patients or financial bonus
(pay-for-performance))
Value-Based Competition - ANSWER: excellent providers receive more patients and
the patients benefit from excellent care.
Provider that can't keep up should restructure or go out of business
Isssue with Dutch health care - ANSWER: - fragmented
- pay incentivizes volume ipv value
- measure with process indicators ipv outcome indicators
- need to be a balance between measuring for accountability and measuring for
improvement
- need for orchestrated teams that take responsibility for full cycle of care
What patients value - ANSWER: - patient level: uniqueness + autonomy
- interaction level: partnership + empowerment
- professional level: compassion + professionalism + responsiveness
Porters three tiers - ANSWER: 1: health status achieved/retained + survival rate
2: recovery time + time to remission
3: sustainability of health/recovery + disease recurrence
PREM's - ANSWER: Patient reported experience measures:
Patient satisfaction; doctor takes me seriously, listened carefully etc
