Achieving Great Outcomes for Great Value

24th April, 2018:  5:45 – 8:15 pm

Let’s get an understanding of Value-based Healthcare!  Achieving the best outcomes and experience for patients is an overarching goal of any health system.  Value-based Healthcare provides a way of quantifying this goal.

With our wonderful, long-time sponsors EY, the Australian Health Network invites you to join us for our discussion on value-based healthcare entitled:  “Achieving Great Outcomes for Great Value”.

What exactly is Value-based Healthcare?  At its most simple level, value is defined as patient outcomes per dollar spent.  It’s not a novel concept to an economist but it made a huge splash when Michael Porter published “What is Value in Health Care?” in the New England Journal of Medicine in 2010.

Many countries have been implementing various components of value-based healthcare (UK, Sweden and USA).  Great examples exist here in Australia:  Dental Health Services Victoria is starting the journey and, similarly, our private health insurance companies are driving towards a value agenda.

It’s now a major topic of conversation for national and state governments which are striving to achieve cost containment in the face of ever-increasing demand, particularly from people who would benefit from an integrated, seamless system.

This model places the patient’s outcome as the focus for improvement in relation to cost, providing a unifying goal for the patient, individual clinicians, provider organisations and system stewards to work toward.  More importantly, the model provides an opportunity for any healthcare system to deliver the best and highest quality care while ensuring we retain an efficient system overall.  Broadly, there are 6 elements that comprise Value-based Healthcare:

1.     Integrated Practice Units

An Integrated Practice Unit includes all clinicians and non-clinical team members who provide care for the patient along their entire journey.

2.     Measure outcomes and costs for every patient

It’s important to measure patient-reported outcomes as well as clinical outcomes for patients, alongside the true costs of the care itself.  Both measures need to go beyond the organisation’s wall and should embrace the entire medical condition (and all aspects) rather than just the specialty level.

3.     Move to bundled payments for care cycles

The two dominant models of payment are:  capitation (a single payment that covers all of the patient’s needs and which rewards cost containment, not outcomes) and fee-for-service (which rewards volume / throughput, not outcomes).  A bundled payment model, which focuses on the patient’s outcome but is adjusted for severity or for a certain cohort of patients, is likely to support a value-based model.

4.     Integrate care delivery systems

This includes defining the scope of services provided, concentrating volume in fewer locations, ensuring the service location meets the acuity and that there’s a supporting system that integrates the patient’s care across a number of different locations.

5.     Expand geographic reach

This may be through a hub-and-spoke model.

6.     Build an enabling information technology platform

This is the enabler / integrator of the 5 models above.  Critically, the differentiating feature is that:  it’s centred on patients; it uses common data definitions; it encompasses all types of patient data; the medical record is accessible to all parties involved in care; it utilises templates; and it’s easy to access and extract information.

To help provide additional perspective, we’ve also included supplementary references below for further information:

New England Journal of Medicine: “What is Value in Health Care” with Michael Porter references

Harvard Business Review: the-strategy-that-will-fix-health-care

Don’t miss our evening with our experts involved in implementing value-based healthcare as they share their experiences:

  • Dr. David Rankin – Clinical Director, Governance, Research, Innovation and Product Healthcare and Strategy, Medibank;
  • Prof. Meinir (Mei) Krishnasamy – Chair in Cancer Nursing, University of Melbourne (moderator);
  • Raj Verma – Director Clinical Program Design and Implementation, NSW Agency for Clinical Innovation; and
  • Dr. Zoe Wainer – Senior Advisor, Dep’t of the Prime Minister and Cabinet; Chair of the Board, Dental Health Services Victoria; and Head of Public Health, Bupa

This is bound to be another lively, informative discussion and terrific evening.  Be sure not to miss out!