Everybody’s Talking About Value-Based Health Care. Here’s What They’re Not Saying.

Author(s): Sachin H. Jain
Source: https://www.forbes.com/sites/sachinjain/2022/04/12/what-is-value-based-healthcare-really/?sh=14d3d84fd8af

Nathan Walcker's Thoughts

Thought-provoking oped highlighting the underbelly of buzzwords in healthcare today. The shift from volume to value that we’ve seen unfold over the past 3-5 years has moved front and center in many conversations, yet remains elusive insofar as its definition and implementation. This article rightly calls out that value is ultimately in the eye of the beholder, and yet there’s no disputing that doing what’s right for the patient trumps all.

Attend any healthcare conference and you’ll quickly discover that it’s become downright fashionable for healthcare leaders to talk about their unwavering commitment to “value-based care.”

The expression has become ubiquitous in healthcare circles. Its virtuousness goes unchallenged.

But should that be the case?

Michael E. Porter and Elizabeth Teisberg (with whom I worked as a student and researcher at Harvard Business School from 2006-2010) popularized the value equation (Value = Quality/Cost) and suggested that improving value should be any healthcare system leader’s highest aim.

Since that time, the federal government has introduced a number of policy instruments to accelerate the transition to value-based care including Medicare Advantage, accountable care organizations, and bundled payment models.

Countless new startups have arisen with the intent of bringing value-based care to the masses.

And big box retailers such as CVS, Walgreens, and Walmart, too, have jumped on the value bandwagon.

The underlying principle of “value-based care” is simple enough—managing to a lower cost of care for a population of patients, while aiming to improve outcomes.

But what does this value-based care look like in practice in the real-world of patient care (beyond the industry conference jargon and academic expositions on the subject)?

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Author Affiliations

Sachin H. Jain is President and CEO of SCAN Group and Health Plan, a $3.4B non-profit entity that serves over 220,000 patients. He is also a physician at the US Department of Veterans Affairs. He was previously president and chief executive officer of the CareMore and Aspire Health, the care delivery divisions of Anthem. He is also Adjunct Professor of Medicine at Stanford University School of Medicine and Co-Editor-in-Chief, Healthcare: the Journal of Delivery Science and Innovation. Sachin trained in internal medicine at Boston’s Brigham and Women’s Hospital and received his undergraduate (AB), medical (MD), and business degrees (MBA) from Harvard.

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