8 Chapter 1 VALUE-BASED HEALTHCARE THEORY Value-based healthcare (VBHC) is regarded as an important innovation to reform healthcare practices and policy 1. It was first introduced in 2006 by Michael Porter and Elizabeth Teisberg as a strategy to combat rising healthcare costs and unwanted variation in quality of care and outcomes 2. According to the VBHC framework, healthcare organizations should aim to maximize patient value, where value is defined as the health outcomes that matter to patients relative to the cost of achieving those outcomes 3. Within VBHC, value for patients is created over the entire cycle of care, and outcomes and costs should be measured across the full cycle of interdependent activities for patients with a specific medical condition 2,4,5. By maximizing patient value, VBHC can contribute to the achievement of the “quadruple aim” of improving both patient and healthcare professionals experiences with care, improving population health, as well as reducing the cost of care 6,7. To facilitate the transformation towards VBHC, Porter and Lee developed the value agenda, which consists of six interdependent and mutually reinforcing components: 1) organize care into integrated practice units (IPUs) around the patient’s medical condition, 2) measure outcomes and costs for every patient, 3) move to bundled payments across the whole care cycle, 4) integrate care delivery across separate facilities, 5) expand excellent services across geographical locations, and 6) build an enabling information technology (IT) platform 3. This value agenda, however, provides little guidance on which practical steps should be undertaken and what aspects should be prioritized to transform healthcare towards VBHC 8. In addition, the value agenda does not describe how the measurement of outcomes and costs for every patient can be used to improve quality of care 9. In 2022, van der Nat therefore proposed a new strategy agenda with four additional components: 1) set up value-based quality improvement, 2) integrate value in patient communication, 3) invest in a culture of value-delivery (education), and 4) build learning platforms for healthcare professionals 9 (Figure 1).
RkJQdWJsaXNoZXIy MTk4NDMw