Value in Healthcare

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Value is created in an industry when quality and experience are balanced with an appropriate cost. Until recently, though, value creation through improved quality and/or experience has not been an intentional priority of healthcare. A major cause of our misguided efforts is our disconnected volume-based, fee for service healthcare model, paid by a third party that is not the actual consumer of the services and that only incentivizes price and volume. This disconnect of purpose and priorities leaves patients, providers, and staff to feel like widgets, commodities, and cogs in the healthcare delivery machine we have operated since the early 20th century. As the healthcare costs in the US continue to go up without an offsetting rise in quality outcomes or patient (or provider) experience, the quest for value has begun. This book explores the key differences between a volume-based health system versus one focused on value, and it offers a framework for value creation, based on the principles of Population Health Management. Patient risks need to be identified, individualized plans of care must be built, and the execution of the plan must be performed in a communicative and collaborative manner, longitudinally supporting and guiding the patient using an appropriate application of relationship and technology. By active creation of value in healthcare, we can rein in costs while improving quality outcomes and experience of the patients and providers. Such a system will allow patients to feel cared for as we guide them on their path toward the optimization of their health and well-being.