To implement value-based health care is to play the long game

Friday, October 11, 2019

‘The concept of value-based healthcare underpins a new health system best suited to today’s health needs—but integrating it with the system we have is to play the long game’, says Australian Healthcare and Hospitals Association (AHHA) Acting Chief Executive Dr Linc Thurecht.

Dr Thurecht was commenting on today’s release by AHHA’s Deeble Institute for Health Policy Research of a Perspectives Brief, Towards value-based healthcare: Lessons learnt from implementing outcomes measures.

The Brief, written by a research team led by Professor Christobel Saunders from the University of Western Australia, reflects lessons learned from implementing a value-based healthcare initiative, the Continuous Improvement in Care–Cancer (CIC Cancer) Project.

The project seeks to bring value-based healthcare principles to cancer management in private and public healthcare settings in Western Australia.

‘Value-based health care is about achieving outcomes that matter to patients relative to the costs of achieving those outcomes’, Dr Thurecht said.

‘To do that properly we first need to measure the outcomes that are important to patients.

‘Second, we need to be able to capture the costs of their care across the full cycle of their care.

‘Then we need to rigorously analyse and interpret these data in order to best match care to the needs of patients, as well as adapt health cost funding models as required to fairly reward caregivers while also providing best value to governments and patients.’

Professor Saunders said that through experiences so far with the CIC Cancer project, the research team had learned some valuable lessons in four main areas: planning and governance; engagement and expectation management; data issues; and information technology systems.

‘With governance, the challenge is that care pathways typically involve many health providers and healthcare sites, and researchers necessarily have to be assembled from more than one institution in order to have the necessary expertise on hand. Multi-site project management, with attendant funding, legal and ethics agreements, need to be settled early or projects can be delayed for up to a year.

‘With engaging clinicians, consumers and stakeholders, expectations have to be managed well, especially regarding the potential for delays. With consumers, there can be problems with full involvement, partly because revisiting a cancer diagnosis can be distressing, and some patients can become too ill to participate.

‘Data consistency, capture and relevance issues will vary with individual projects, and some of the specific problems we encountered are set out in the Brief.

‘Finally, we found that commercial data collection systems do not as yet fully meet the complex tailoring, integration and linkage requirements typically needed with health data. Development of an adaptable open source system is possibly a cheaper way to go. At the moment we have three parameters—fast, good and cheap—of which we can only have two!’ Professor Saunders said.

Towards value-based healthcare: Lessons learnt from implementing outcomes measures is available here.

More information on AHHA is available at ahha.asn.au

The Australian Healthcare and Hospitals Association is the national peak body for public and not‑for‑profit hospitals, Primary Health Networks, and community and primary healthcare services.

Media enquiries: Prof. Christobel Saunders, 0438 943 358