Value in Healthcare

supervision of dr. Abdullah Khoja

Value in Healthcare
Asem shadid
435032467
 Value-based healthcare, also known as
value-based care, is a payment model that
rewards healthcare providers for providing
quality care to patients.
Under this approach, providers seek to
What Is Value in achieve the triple aim of providing better
Health Care? care for patients and better health for
populations at a lower cost.

https://www.nejm.org/doi/full/10.1056/nejmp1011024
 Value-based healthcare is a healthcare
delivery model in which providers,
including hospitals and physicians, are
paid based on patient health outcomes.

What is the Under value-based care agreements,

concept? providers are rewarded for helping patients
to:
 Improve their health
reduce the effects and incidence of chronic
disease
To live healthier lives in an evidence-based
way.
 Costs are growing at roughly double the rate
of growth in gross domestic product (GDP),1
 Which is putting severe pressure on
healthcare budgets, limiting the potential for
Problem: meaningful innovation
. Some countries, even leading to rationing in
the form of longer waiting times or restricted
access.
 Growing evidence indicates that a significant
portion of healthcare spending – as much as
30% is wasted on unproven or unnecessary
treatments.
Thus, quality of care delivered varies widely
Problem cont. across different provider institutions
  The fundamental principle of value in healthcare is:
 first, to align industry stakeholders around the common objective
of improving health outcomes delivered to patients at a given
cost.
Value-Based  second to give stakeholders
Healthcare  the autonomy
 the right tools
 the accountability

to pursue the most rational ways of delivering value to patients.

  Recently, however, a new development has
emerged in response to these problems.
 Some of the industry’s leading stakeholders
have begun to redefine their mission and their
operating model to focus on improving
examples healthcare value, or the health outcomes that
matter to patients relative to the resources or
costs required.
 Consider the following illustrative examples:
Example (1)
 In India, the Aravind Eye Care System, a network of
hospitals dedicated to providing low-cost, high-quality
Example (1) cataract surgery

 It combines systematic tracking of health outcomes

with an integrated approach to care delivery.

Had same result of world best providers approximately

10% of the cost per surgery in the United States!!
Example (2)
 In Germany, Martini-Klinik, a prostate cancer
centre at the University Hospital Hamburg-
Eppendorf, collects comprehensive data on its
patients’ health outcomes
Example (2)
That includes documentation of all post-
surgical complications down to the level of
individual surgeons, and uses the data to
continuously improve its performance in
prostate cancer care.
Example (3)
 In the United States, Kaiser Permanente (KP), an
integrated payer-provider, has created an integrated
care delivery model that emphasizes preventive care
and the active management of chronic disease, and
includes incentives that simultaneously promote
excellent clinical outcomes and resource efficiency.
KP has been able to provide employers with health
Example (3) benefits that are, on average, 10-20% more cost-
effective than traditional managed-care plans, while
delivering outstanding quality.
In 2012-2014, its health plans took the top three spots
in the US National Center for Quality Assurance
(NCQA) Medicare plan rankings, and the company’s
commercial plans were in the top 10% of the NCQA’s
ranking of national commercial plans. In addition, KP
consistently has the highest member satisfaction in its
markets.
Example (4)
 In Sweden, more than 100 quality registries covering the majority
of national health expenditure systematically track health
outcomes for patients suffering from a specific condition or
disease. The accumulating body of data has allowed Swedish
clinicians to identify which providers deliver the best outcomes,
codify their clinical best practices and share them with other
providers, thus improving average health outcomes over time.
Example (4)
A recent study demonstrated that 30-day mortality after acute
myocardial infarction is 37% higher in the United Kingdom than in
Sweden. 4 Researchers are leveraging the provider networks
affiliated with Sweden’s quality registries to conduct clinical trials
evaluating the effectiveness of treatments and procedures, at
roughly 10% of the cost of traditional clinical trials.
QUESTIONS?
Value in Healthcare
By
Faisal Eid Almutairi
435031637
 • Unsustainable rise in healthcare costs.

• Payers try to control costs by imposing

constraints on medical decision-making and
Defining the patient choice.
problems
• The exponential growth in biomedical
knowledge.
Defining the • Increase in medical specialties.
problems
• Treating illness: providing care to those already
ill. Leading to underinvesement in prevention
and public health.
 • Value in Healthcare project in July 2016 was
Value in launched by The World Economic Forum, in
Healthcare collaboration with The Boston Consulting
Group (BCG).
Project
• The project takes a systemic approach to
value-based healthcare.
 • Project goals:
1. develop a comprehensive understanding of the key
components of value-based health systems.
2. Draw general lessons about the effective
implementation of value-based healthcare by
Value in codifying best practice at leading healthcare
institutions around the world.
Healthcare 3. Identify the potential obstacles preventing
Project in 2016 health systems from delivering better
outcomes that matter to patients, and at lower
cost.
4. Define priorities for industry stakeholders to
accelerate the adoption of value-based models
for delivering care.
 •It developed:
• A detailed taxonomy of the components of a value-
based health system.
• Prepared case studies of leading stakeholders that
illustrate best practices in the field.
• Identified some of the main barriers that hinder
further adoption of value-based healthcare.
Value in
• Devised a preliminary roadmap for health systems
Healthcare to adopt to make them truly patient-centric.
Project in 2016
 • Identified some of the main barriers that hinder
further adoption of value-based healthcare.
Value in
Healthcare
• Devised a preliminary roadmap for health
Project in 2016 systems to adopt to make them truly patient-
centric.
 • Value in Healthcare project session held at the
world economic forum annual meeting 2017.

• Focused on:
Value in • Defining the problem.
Healthcare • Developing a comprehensive framework for a
value-based health system.
• Suggesting a roadmap for system
transformation.
QUESTIONS?
Mohammed Buraik
Alosaimi
435031603
Regardless of the sector’s extraordinary achievements over the past century, global
healthcare is marked by growing concern over its sustainability.

 Specifically , costs are growing at roughly double the rate of growth in gross
domestic product, putting extreme pressure on healthcare budgets and
restricting further development.

Value-based healthcare is a genuinely patient-centric way to design and

manage health systems.

In Comparison to what health systems currently provide, it has the

potential to deliver substantially improved health outcomes at
significantly lower cost.
  Despite some progress, value based health care
hasn’t gone nationally in any of the countries
that adopted it
Progress and
obstacles  It all faced a common obstacle; how the
traditional health care institutions are built
 Traditional
Health care
institutions

Financial Non-financial
Organization Regulation
incentives incentives
  We have 4 keys that enable us to achieve a value based health care

How to
achieve a value
based health
care
  health informatics, to facilitate the easy
collection, analysis and sharing of outcomes
and cost data

Health
Informatics
Benchmarking
 to leverage data on outcomes and the costs for
, research and clinical practice improvement and innovation
tools
Value based  to create incentives for all stakeholders to
payments focus on value
  in organizing care delivery, to improve coordination across the
Innovations health system
Nawaf Abdullah Alosaimi

434029628
 Health care is highly regulated industry that’s
why public policy has a critical role to play in
Regulation enabling the value-based transformation.
And Policy
 Policy makers should mandate:
1-tracking of health outcomes and set standards
for data collection, analysis and transparency.

Regulation 2-balance the trade-off between patient privacy

And Policy and data sharing.
 3-enable cooperation,coordination and
partnerships along care pathways while
protecting against conflict of interest.
Regulation
And Policy 4-establish new payment models that support
improvement in patient value.
 5-Making new policy that makes it easier to hold
Regulation pharmacological and medical companies
And Policy accountable while contributing more actively to
health care value.
Abdulrahman Mishal
Alharbi
435031643
  The fundamental principle of value in healthcare is, first to align
industry stakeholders around the shared objective of improving
health outcomes delivered to patients for a given cost

What value
means in Health outcome matter to patient
Value =
healthcare ? Cost of delivering that outcomes
 1- Three foundational principles of value-based care
delivery:
The system’s
 A) the systematic measurement of the health outcomes that
main parts can
matter to patients and the costs required to deliver those
be clustered into
outcomes across the full cycle of care
three broad
 B) the identification of clearly defined population segments and
areas
the specific health outcomes and costs associated with those
segments

 C) the development of customized segment-specific interventions

to improve value for each population segment.
The system’s main 2- Four key enablers of
parts can be value in healthcare
clustered into  Informatics – including shared standards and
three broad areas new capabilities that enable the routine
collection, sharing and analysis of outcomes
data and other relevant information for each
population segment

 Benchmarking, research and tools – including

systematic benchmarking for continuous
improvement by identification of variations in
responses to treatment and the emergence
of clinical best practices
The system’s
3- Public policy
main parts can
be clustered
 Payments – including new forms of compensation and reimbursement
into three broad that help to improve patient value
areas
 Delivery organization – including new roles and organizational models
that allow providers and suppliers to adapt to new opportunities and
innovations, provide better access to appropriate care and engage
clinicians in continuous improvement
Thank you