VBHC - week 1 Flashcards
Micheal porter
- Value chain:
o All the activities business organization performs, which together create a valuable product or service - Central premise:
o In any industry, a successful and sustainable enterprise needs to create value for its clients – particularly in a competitive market - If you want to maintain a successful organization, you need to provide value for your clients. You also need to keep up witch improvement from competitors, otherwise your clients might go elsewhere. Porter used to focus on the US, his remarks are applicable to many other systems.
value
outcomes/ costs
What do patients want?
- To get better
à Best possible treatment outcomes: the outcomes of treatments are highly important to patients. Outcomes are one element of value. But there is another element to “value”. The people that provide (people working in healthcare) healthcare are getting something in return for their energy/performance.
à Treatments come at a price, we pay our healthcare professionals (trough health insurance in this country, some pay directly for a service).
o Some treatments are more expensive than others
o Some providers charge higher prices than others for the exact same treatment
If 2 providers/treatments have the exact same outcome, we should go for the less costly one.
key principle of value (IMPORTANT)
Value in health care is created at the level of medical conditions, over the full cycle of care
Integrated Practice Unit (IPU)
multidisciplinary team, coordinating all the services necessary to address a medical condition
Value-based competition
- Excellent providers rewarded with more patients, more patients receiving excellent care
- Providers that cannot keep up should restructure or go out of business (which would be good for patient value!) it may then be the best for the patients.
“If value improves, patients, payers, providers and suppliers can all benefit while the economic sustainability increases” (Porter 2010)
Integrated care
‘A coherent and coordinated set of services which are planned, managed and delivered to individual service users across a range of organizations and by a range of co-operating professionals and informal carers’ (Minkman, 2012, p. 8, Raak et al., 2003)
porter and health care goal
goal = patient value
why conclude that value = outcomes/ costs?
value is what matters most to patients, so outcomes over costs
what do patients value?
The health status they achieve (outcomes) and the price they have to pay for it (costs)
value=outcomes/costs
Optimizing this equation becomes the central goal –> the best outcomes, as efficiently as possible.
Implications for payment
Value-based payment covers the full care cycle of a certain condition.
* Bundled payments that cover all the necessary activities.
* For chronic conditions, bundled payments covering episodes of care.
Payments should cover full medical bill of all services and activities that were needed
VBHC
- Integrated care
- Shared decision making
- Measuring outcomes and costs
- Benchmarking health care providers
- Value based payments
What is value based healthcare?
The optimal balance between the gain in health, costs and societal value in light of characteristics of the individual patient (personality, preferences, socio-economic, status, comorbidity, grade of disease etc.) = data-driven health care
What is value based healthcare?
The optimal balance between the gain in health, costs and societal value in light of characteristics of the individual patient (personality, preferences, socio-economic, status, comorbidity, grade of disease etc.) = data-driven health care
Dashboard
- Clear view on the patient status
- Longitudinal monitoring and bench marking – fear
o People at the same stage in their disease, so you know what care to give them
