Redefining Care Delivery

At a time when healthcare expenditures are on the rise, a new concept for care delivery is taking roots -- value-based healthcare or the patient health outcome per dollar spent. This model of care delivery focuses on the outcome delivered by the care provider rather than just the cost of delivering it or the financial success of the stakeholders.

Value-based healthcare determines the value of the procedure based on various parameters. These include quality care, cost containment, patient safety and satisfaction. The focus throughout the treatment cycle is on providing the patient with better health. Under this system poor outcomes waste, reworks, such as re-operations, readmissions are discouraged.

According to records, in US, 20-30 per cent of all prescriptions, visits, procedures and hospitalisations are overused, underused (including non-used) and misused. It is also estimated that for every million dollars spent on healthcare more than an estimated US$ 200,000 is likely to be wasted and is potentially causing patient harms.

The new service and payment models involved with the value-based healthcare system need to evolve and healthcare organisations are being forced to tag on this.

Organisation leadership is the key to migrating to this new form of care. Leaders need to push for a fundamental restructuring of healthcare delivery and put in place systems that measure various processes for the kind of outcomes they provide. Considering the relationship of quality care to cost/expenses and patient/customer satisfaction, the cost of the intervention has to be analysed to determine the value.

According to Gloria N Eldridge, Senior Analyst and Project Director, Altarum Institute, after one or two decades, other players will begin to adopt these value-based healthcare strategies as administrative, reporting, and payment systems begin to merge due to the power of Medicare, in particular, to drive market change.

The true value-based healthcare system can be accomplished only when physicians realise that concentrating on patient satisfaction gives more meaning rather concentration on money factors and accept these changes.

The cover story in this issue of Asian Hospital & Healthcare Management, features experts views on quantifying the value of healthcare.

Yosef D Dlugacz, Senior Vice President and Chief of Clinical Quality, Education & Research, Krasnoff Quality Management Institute, USA talks about how the traditional and accepted procedures are being reevaluated for value and how the concept of value has changed dramatically during past few years. Gloria N. Eldridge, Senior Analyst and Project Director, Strategic Innovations for Affordable, Sustainable Healthcare: A Model for Health System Reform, Altarum Institute talks about how the value-based healthcare can affect US healthcare.

Prasanthi Potluri

Prasanthi Potluri