9 1 General introduction 1 Measure outcomes and cost for very patient 2 Set up valuebased quality improvement 3 Integrate value in patient communication 4 Organize care into Integrated Practice Units (IPUs) 5 Move to bundled payments for care cycles 6 Integrate care delivery across separate facilities 7 Expand excellent services across geographic 9 Build learning platforms for healthcare professionals 10 Build an enabling information technology (IT) platform 8 Invest in a culture of value delivery (education) Figure 1: The new strategic agenda as proposed by van der Nat, 2022. Figure was adapted based on van der Nat, 2022 and Porter and Lee, 2013. VALUE-BASED HEALTHCARE IN THE DUTCH CONTEXT This new strategy agenda is consistent with the Dutch interpretation of VBHC. This interpretation deviates slightly from the original concept, bypassing the immediate need to measure cost while advocating the collection and use of outcome information. More specifically in the Netherlands, emphasis is placed on the use of outcome information to support shared decision making, continuous learning and quality improvement 8-11. From 2011 onwards, hospitals in the Netherlands have been implementing VBHC principles into healthcare provided by medical professionals 12,13. Many hospitals have started with the systematic measurement of outcomes that matter to patients in routine care or by organizing care around medical conditions 9,14-17. The successes of some of these earlier initiatives, combined with the notion that VBHC is able to optimize both care for patients and resource allocation, has led to a widespread implementation of VBHC in the Netherlands 18. This development is supported by the Dutch Ministry of Health, Welfare and Sports with initiatives
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