Value based healthcare

1. Value in Healthcare
supervision of dr. Abdullah Khoja

2. Value in Healthcare
Asem shadid
435032467

3. What IsValue in
HealthCare?
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
achieve the triple aim of providing better
care for patients and better health for
populations at a lower cost.
https://www.nejm.org/doi/full/10.1056/nejmp1011024

4. What is the
concept?
Value-based healthcare is a healthcare
delivery model in which providers,
including hospitals and physicians, are
paid based on patient health outcomes.
Under value-based care agreements,
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.

5. Problem:
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
meaningful innovation
Some countries, even leading to rationing in
the form of longer waiting times or restricted
access.
 .

6. Problem cont.
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
across different provider institutions

7. Value-Based
Healthcare
 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.
 second to give stakeholders
 the autonomy
 the right tools
 the accountability
to pursue the most rational ways of delivering value to patients.

8. examples
 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
healthcare value, or the health outcomes that
matter to patients relative to the resources or
costs required.
 Consider the following illustrative examples:

10. Example (1)

11. Example (1)
In India, the Aravind Eye Care System, a network of
hospitals dedicated to providing low-cost, high-quality
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!!

12. Example (2)

13. Example (2)
In Germany, Martini-Klinik, a prostate cancer
centre at the University Hospital Hamburg-
Eppendorf, collects comprehensive data on its
patients’ health outcomes
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.

14. Example (3)

15. 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
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.

16. Example (4)

17. 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.
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.

18. QUESTIONS?

19. Value in Healthcare
By
Faisal Eid Almutairi
435031637

20. Defining the
problems
• Unsustainable rise in healthcare costs.
• Payers try to control costs by imposing
constraints on medical decision-making and
patient choice.
• The exponential growth in biomedical
knowledge.

21. Defining the
problems
• Increase in medical specialties.
• Treating illness: providing care to those already
ill. Leading to underinvesement in prevention
and public health.

22. Value in
Healthcare
Project
• Value in Healthcare project in July 2016 was
launched byTheWorld Economic Forum, in
collaboration withThe Boston Consulting
Group (BCG).
• The project takes a systemic approach to
value-based healthcare.

23. Value in
Healthcare
Project in 2016
• 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
codifying best practice at leading healthcare
institutions around the world.
3. Identify the potential obstacles preventing
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.

24. Value in
Healthcare
Project in 2016
•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.
• Devised a preliminary roadmap for health systems
to adopt to make them truly patient-centric.

25. Value in
Healthcare
Project in 2016
• Identified some of the main barriers that hinder
further adoption of value-based healthcare.
• Devised a preliminary roadmap for health
systems to adopt to make them truly patient-
centric.

26. Value in
Healthcare
• Value in Healthcare project session held at the
world economic forum annual meeting 2017.
• Focused on:
• Defining the problem.
• Developing a comprehensive framework for a
value-based health system.
• Suggesting a roadmap for system
transformation.

27. QUESTIONS?

28. Mohammed Buraik
Alosaimi
435031603

29. 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.
Regardless of the sector’s extraordinary achievements over the past century, global
healthcare is marked by growing concern over its sustainability.
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.

30. Progress and
obstacles
 Despite some progress, value based health care
hasn’t gone nationally in any of the countries
that adopted it
 It all faced a common obstacle; how the
traditional health care institutions are built

31. Traditional
Health care
institutions
Organization Regulation
Financial
incentives
Non-financial
incentives

32. How to
achieve a value
based health
care
 We have 4 keys that enable us to achieve a value based health care

33. Health
Informatics
 health informatics, to facilitate the easy
collection, analysis and sharing of outcomes
and cost data

34. Benchmarking
, research and
tools
 to leverage data on outcomes and the costs for
clinical practice improvement and innovation

35. Value based
payments
 to create incentives for all stakeholders to
focus on value

36. Innovations
 in organizing care delivery, to improve coordination across the
health system

37. NawafAbdullah Alosaimi
434029628

38. Regulation
And Policy
Health care is highly regulated industry that’s
why public policy has a critical role to play in
enabling the value-based transformation.

39. Regulation
And Policy
Policy makers should mandate:
1-tracking of health outcomes and set standards
for data collection, analysis and transparency.
2-balance the trade-off between patient privacy
and data sharing.

40. Regulation
And Policy
3-enable cooperation,coordination and
partnerships along care pathways while
protecting against conflict of interest.
4-establish new payment models that support
improvement in patient value.

41. Regulation
And Policy
5-Making new policy that makes it easier to hold
pharmacological and medical companies
accountable while contributing more actively to
health care value.

42. Abdulrahman Mishal
Alharbi
435031643

43. What value
means in
healthcare ?
 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
Health outcome matter to patient
Cost of delivering that outcomes
Value =

44. The system’s
main parts can
be clustered into
three broad
areas
1-Three foundational principles of value-based care
delivery:
 A) the systematic measurement of the health outcomes that
matter to patients and the costs required to deliver those
outcomes across the full cycle of care
 B) the identification of clearly defined population segments and
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.

45. The system’s main
parts can be
clustered into
three broad areas
2- Four key enablers of
value in healthcare
 Informatics – including shared standards and
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

46.  Payments – including new forms of compensation and reimbursement
that help to improve patient value
 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
3- Public policy
The system’s
main parts can
be clustered
into three broad
areas

48. Thank you