Inside Intel from the ReviveHealth Summit: How Patients Define Value
In healthcare, payors, providers, employers, and patients alike want to deliver and receive the best value. That part of the equation is simple. The complicated part? They don’t define value in the same way. Perhaps this is why there’s a dismal state of trust among the key stakeholders in healthcare (ReviveHealth Trust Index™).
For providers, value is defined by the effectiveness and efficiency of providing safe care that produces quality outcomes for their patients.
For payors, value is defined by keeping their members out of expensive care settings, having members that are healthier, and transitioning risk (for example, the shift from fully-insured to self-insured).
For employers, it’s a combination of cost and quality that defines value. Are their employees satisfied with their healthcare benefits? Does the quality of their network match the cost that they pay for it?
But what about the biggest stakeholder in this equation? Similar to employers, the majority of patients define value by quality, followed by cost and service — although, no two patients are the same, and we shouldn’t expect their definition of value to be either.(1)
So, how do we pull these definitions together to benefit everyone?
The current initiatives driving the shift towards value-based care look to address the ambiguity of value by implementing boundaries that create value-based standards. As Brandon mentioned in his Two Things He Learned at Our 2018 Summit, it’s no secret that this shift towards value-based care has slowed its progress to a near idle speed, with revenue from value-based payments turning up well-below expectations. But perhaps there’s been a slow-down in progress because it needs to be approached differently.
Patient care isn’t one-size-fits-all, and it shouldn’t be treated as such.
As concluded by a HealthAffairs piece examining CareFirst BlueCross BlueShield’s patient-centered medical home program, and as Nate Kaufman reiterated in his session on Healthcare: We Have a Problem, “identifying target patients may be more important than building capacity to provide patient-centered care to all.”(2)
By identifying and addressing the needs of specific sections of a patient population, there’s a better chance of providing a tailored approach to care that will help to reduce costs and improve quality – the two most prominent factors in the average patient’s definition of value.
As the CareFirst example shows us, despite these varying definitions, the mixed results, and the fact that value-based care has missed the mark on initial expectations, achieving better quality, lower cost, and stakeholder satisfaction, is possible – it’s just going to require more time and up-front investment to achieve.
(1)“How Do Healthcare Consumers Define Value in Patient-Centered Care?” PatientEngagementHIT.com. Sara Heath. December 4, 2017.
(2) “What Should We Conclude From ‘Mixed’ Results In Payment Reform Evaluations?” HealthAffairs. Len Nichols, Alison E. Cuellar, Lorens Helmchen, Gilbert Gimm, Jay Want. August 14, 2017.