The next phase in the implementation of value-based healthcare: Adding patient-relevant cost drivers to existing outcome measure sets

ABSTRACT

Healthcare expenditure is increasing worldwide and value-based healthcare (VBHC) was introduced as a strategy to improve outcomes and prevent further rises in costs. Monitoring outcomes and costs forms the basis for the implementation of VBHC. Through the efforts already made in the area of outcome monitoring, providers have gained insight into their performance allowing for increasing patient value (PV), defined as patient-relevant outcomes divided by costs of healthcare delivery. However, diminished outcome variation in many benchmarks and the lack of connection between clinical outcomes and costs in clinical practise warrant the debate on the sustainability of current outcome monitoring practises. Cost parameters are currently scarcely incorporated in routine outcome monitoring and adding cost parameters would therefore yield improvement potential of PV. In this viewpoint, we discuss currently used methods for costs calculation within the scope of VBHC and propose a novel, patient-centred and less labour-intensive approach we believe can be used in conjunction with clinical outcome monitoring. That is, the selection of disease/treatment-specific cost drivers and their structural embedment in routine clinical outcome monitoring.

KEYWORDS:

• Value-based healthcare
• quality improvement
• outcome measurement
• patient value
• patient-reported outcome measures
• costs

Disclosure statement

No potential conflict of interest was reported by the author(s).

Sources of funding

The author(s) reported there is no funding associated with the work featured in this article.

Additional information

Notes on contributors

Gijs J. van Steenbergen

Gijs J. van Steenbergen is physician affiliated with the Catharina Heart centre. GJ van Steenbergen is a PhD candidate in value based healthcare.

Paul Cremers

Paul Cremers is CEO of the Dutch regional cardiac registry.

Lukas Dekker

Prof Lukas Dekker is physician affiliated with the Catharina Heart centre. Prof Lukas Dekker has a chair in value-based healthcare and has expertise in value based outcome improvement within healthcare.

Dennis van Veghel

Dennis van Veghel is CEO of the Dutch national cardiac registry.