Value Based Healthcare Is The Way Of The Future

The healthcare system around the globe is experiencing a paradigm shift. The patient is becoming the central focus for all stakeholders in the healthcare system – physicians, payers and suppliers. Globally, the healthcare cost is soaring, and with the ever rising demand for good quality healthcare at affordable cost for the exponentially increasing population, a cost effective, outcome driven, accessible solution is the need of the hour.

Healthcare systems around the world are adopting the practice of Value Based Health Care (VBHC) and more often than not, it is proving to be the answer we need.

What is Value Based Health Care?

Value Based Health Care makes the patient, their health, convenience and care the top priority.

VBHC motivates and rewards those healthcare providers who deliver the best healthcare outcomes to their patients at the lowest possible cost, without compromising quality, and penalizes those who fail to effectively provide the best results to their patients.

All stakeholders in the healthcare ecosystem stand to benefit from this practice. The current fee-for-service model places a huge burden on the payer. In an economy like India, where a majority of the healthcare expenses are out of pocket rather than institution or insurance driven, annually 39 million people are driven to poverty because of their inability to keep up with the high cost of healthcare. A chronic disease striking one individual can have large socio-economic repercussions on all the members of the family.

value_based_careThe shift towards Value Based Health Care is not an easy or immediate process. It requires involvement of everyone in the ecosystem, right from the key decision makers to those implementing them. While the senior leadership of any organisation looking to move towards VBHC must absolutely be on board with utmost commitment, it is important that the rest of the staff takes ownership of this process to ensure effective implementation and provide the best patient experience possible.

Integrated Practice Units (IPUs)

The current hospital structures are scattered by departments, and patients rarely receive specialized, full cycle care for their condition. Interdisciplinary approach is essential to cut costs and maximise outputs. IPUs include a team of specialists such as nurses, physiotherapists, pharmacists, social workers, behavioural therapists, psychologists, etc. led by a physician to closely work with the patient’s condition and provide wholesome care in an organised manner. This allows the whole team to be involved in the patient’s treatment, enabling them to make better, conscious and informed decisions about what is best for the patient and how they can deliver this in a way that is efficient and not expensive.

Measuring costs

A major obstacle in the healthcare system is that providers aren’t aware or trained to monitor costs and make economic decisions. Redundancies in the system and lack of communication between the stakeholders lead to prescriptions and recommendations of a lot of unnecessary provisions that inflate the cost of care. “Cost” must not only be viewed as billing items but as the utility of time, money as well as maximising the capacity of available resources. Providers and institutions must be reimbursed based on value based outcomes, which motivates them to provide excellent care at low costs to increase their margins. Time driven activity based costing is indispensible to VBHC.

Bundled Prices

The current fee-for-service model charges patients and payers for individual services and facilities accessed. A more efficient pricing model is to charge for a full cycle of treatment, including any post treatment complications as well as follow ups for a fixed period of time. In such a model, the patient benefits by receiving wholesome, low cost care. Providers earn better margins and being assisted by specialists in every area of treatment, have their own functionality managed better. Payers see a drastic fall in expense, enabling them to channel resources towards preventive care and early detection of disorders. Suppliers of facilities such as drug manufacturers, upon successful integration into the system by providing low cost commodities see an increased adoption of their products and services, thereby increasing their demand and market share.

System integration and Geographical Expansion

The Indian Healthcare System’s establishment of Primary and Secondary Health Centres is a fantastic starting point to decrease the cost burden and provide optimal, necessary care to patients tailored to their needs. These centres, established to deal with non-acute conditions, and central hubs with sophisticated facilities and highly experienced specialists to deal with emergency and complicated cases enable geographical penetration of healthcare resources and their optimum utilization.

Information Technology Platforms

It is apparent that for smooth implementation of these facets to establish a healthcare system truly driven by value, information technology is indispensable. Value Based Health Care needs standard data and infrastructure. Technology can be a powerful tool in healthcare, and while often is viewed at an increased expense, when used correctly can aid the process of reducing cost and maximising outcomes. Data science is influencing and changing every sector in the world, and it has tremendous potential in healthcare. When clinical data is collected, stored and analysed in a structured manner, it has the ability to aid providers with the information they need to make the best decisions for their patients. Insights about what treatments work best for what types of patients, which is the most cost effective and time saving option, what complications and follow ups can be expected – all of this can be made possible by using technology platforms such as talkadoc into clinical practice. Data from a full cycle of treatment is stored and accessed at a single point by all stake holders, and it also opens up the doors to involving patients in their own treatment and empowering them. Physicians can encourage patients to report their adherence to their treatment protocols, understand short comings and loopholes, maintain transparency and assess the progression of a patient’s conditions – all of this made possible by using the right data with the right tools.

In today’s fast paced world witnessing a paradigm shift towards providing the best options to patients, greater transparency in processes interdisciplinary approach to patient’s health and the use of indispensible data science is the way forward.


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