Value-Based Health Care
Based on the research of Professor Michael Porter, Value-Based Health Care is a framework for restructuring health care systems around the globe with the overarching goal of value for patients.
Key Concepts
Value-based health care is one of the most important topics in health care transformation today. Value-based approaches to organizing care are widely touted as critical to improving the health outcomes of patients worldwide and controlling runaway health care costs. Value-based health care's central tenant is that the overarching principle in redesigning health care delivery systems must be value for patients. We define value as the outcomes that matter to patients and the costs to achieve those outcomes.
There are six major elements that are necessary in a truly value-based system
- Organize Care Around Medical Conditions →
Care delivery is organized around patients' medical conditions or segments of the population.
- Measure Outcomes & Cost for Every Patient →
Outcomes and cost are measured for every patient.
- Aligning Reimbursement with Value →
Reimbursement models that reward both better outcomes and efficiency of care, such as bundled payments.
- Systems Integration →
Regional delivery of care organized around matching the correct provider, treatment, and setting.
- Geography of Care →
National centers of excellence providing care for exceedingly complex patients.
- Information Technology →
An information technology system designed to support the major elements of the agenda.
Resources
Value-Based Health Care Organizations
Since the introduction of value-based health care in 2004, there has been an explosion of information and ideas about value-based health care. Here we publish links to major value oriented organizations in health care.
American College of Surgeons' THRIVE Initiative
On July 18, 2019, the American College of Surgeons (ACS) and Harvard Business School’s (HBS) Institute for Strategy and Competitiveness announced ACS THRIVE (Transforming Health Care Resources to Increase Value and Efficiency), a new program to help hospitals and surgical practices improve surgical patient outcomes while lowering the cost of delivering care. Initially, leaders of the program will pilot the value measurement process with 10–15 hospitals in the United States, focusing on measuring the full cycle of care–including its key surgical, medical, behavioral, and social elements–for three surgical conditions. Results from the pilot will be used to create a scalable approach that all hospitals can use to measure and improve value.
Medical Education, Harvard Medical School
The Medical Education division of Harvard Medical School has just begun a new curriculum for the education of physicians. The new curriculum incorporates pedagogical approaches that foster active learning and critical thinking; earlier clinical experience; and advanced clinical and student-tailored basic/population science experiences that provide customized pathways for every student. In the new curriculum, the core basic/population science needed to succeed in clinical clerkships is taught prior to the core clinical year, while the more advanced science that is more relevant after intensive clinical experience follows completion of the core clinical clerkships. Harvard Medical School has collaborated with Harvard Business School to teach value-based health care in a required course, Essentials of the Profession II, given after students have taken their clinical clerkships.
Petrie-Flom Center for Health Law and Policy, Harvard Law School
The Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School was founded in 2005 through a generous gift from Joseph H. Flom and the Carroll and Milton Petrie Foundation. The Center’s founding mission was to promote interdisciplinary analysis and legal scholarship in these fields. Today, the Center has grown into a leading research program dedicated to the unbiased legal and ethical analysis of pressing questions facing health policymakers, medical professionals, patients, families, and others who influence and are influenced by health care and the health care system. To achieve this goal, the Center fosters a community of leading intellectuals, practitioners, and policymakers from a variety of backgrounds at all stages in their careers, and produces programming and events on a variety of health law policy and bioethics topics. The Center also hosts a leading health law policy blog, The Bill of Health. The Center has partnered with the our health care team to study the legal and regulatory barriers to value-based health care, including fraud and abuse laws such as the Stark law limiting physician referrals, anti-trust laws, data privacy laws limiting information and data sharing, restrictive state licensing requirements, and other regulations.
International Consortium for Health Outcomes Measurement (ICHOM)
ICHOM was created in 2012 by Professor Michael Porter, Dr. Stefan Larsson of the Boston Consulting Group and Dr. Martin Ingvar of the Karolinska Institute. ICHOM's mission is to unlock the potential of value-based health care by defining global standard sets of outcome measures that matter most to patients and driving adoption and reporting of these measures worldwide to create better value for all stakeholders. ICHOM works with patients, leading providers, and registries to enable measuring results by medical condition, from prostate cancer to coronary artery disease. ICHOM supports one of the key strategic agenda items in Professor Porter’s value-based health care delivery framework – measuring outcomes for every patient.
Value Institute for Health and Care at the University of Texas, Austin
The Value Institute for Health and Care is a joint endeavor of Dell Medical School and McCombs School for Business at University of Texas, Austin. Executive Director, Elizabeth Teisberg, PhD and Managing Director, Scott Wallace, MBA, JD lead the Institute on its mission to accelerate transformation to high value health care. Prof. Teisberg, who holds the Cullen Trust Distinguished University Chair for Value-Based Health Care, authored Redefining Health Care: Creating Value-Based Competition on Results with Prof. Michael E. Porter. Prof. Wallace was the first CEO of the National Alliance for Health Information Technology and was appointed by President George W. Bush as Chair of the Federal Commission on Systemic Interoperability. The Value Institute for Health and Care is accelerating value-based transformation through translational research, support for implementation of high value care delivery, a series of executive education programs focused on implementing high value care in practice, and a 1 year master’s in health care transformation for working professionals.
Avant-garde Health
Avant-garde Health was started based on the value-based health care delivery research at Harvard Business School led by Professors Michael Porter and Bob Kaplan. Their CEO Derek Haas worked on the HBS health care team for four years and continues to collaborate with the faculty on research. Avant-garde Health’s analytics software (CareMeasurement.com) enables providers to apply concepts from the research to improve quality and profitability across the care continuum. Derek and Avant-garde Health were recently featured in a book by Professor Howard Stevenson, Problem Solving: HBS Alumni Making a Difference in the World.