Innovators improve care and efficiency
In our July-August digital issue, Rob McGough highlighted the move to value-based healthcare. Here he gives examples of the adoption of this approach in the private healthcare sector.
The adoption of value-based healthcare (VBH) by independent doctors can offer numerous advantages. However, its adoption, in the UK certainly and to an extent internationally also, is currently patchy.
I have set out below examples from a broad geographic spectrum which include elements of value-based approaches.
They demonstrate through a range of initiatives, both with private and public-sector practitioners, that advantages can flow from the development of value-based healthcare:
The Martini Klinik in Hamburg, Germany, specialises in treating patients with prostate cancer. It stands out as a prime example of an organisation that has successfully embraced the principles of value-based healthcare, prioritising patient outcomes and clinical excellence while effectively managing costs.
A key aspect that distinguishes the Martini Klinik is its patient-centred approach. By focusing on outcomes that matter most to patients, such as quality of life and functional improvement, they align care with patients’ goals and preferences.
This approach not only enhances patient satisfaction but also contributes to better clinical outcomes. Through clear measurement and monitoring of patient-reported outcomes, the hospital can also continually evaluate and improve its performance, ensuring that resources are allocated to interventions that yield the greatest benefit.
Optimise cost-effectiveness
The Martini Klinik has made substantial efforts to optimise cost-effectiveness without compromising on quality.
By implementing evidence-based practices and fostering a culture of innovation, the hospital has taken steps to streamline processes, reduce unnecessary tests or procedures and minimise waste.
This judicious resource allocation, coupled with a focus on prevention and early intervention, has resulted in improved patient outcomes and reduced healthcare costs.
It has also embraced greater collaboration and co-ordination among its multidisciplinary teams, fostering shared decision-making and interdisciplinary care.
This integrated approach promotes seamless transitions between different phases of care, reducing fragmentation and improving efficiency.
The US-based Cleveland Clinic has a reputation as an organisation that embraces value-based healthcare to deliver patient outcomes and clinical excellence in a cost-effective manner.
Its 2008 transformation programme re-organised its structure around patient groups/disease areas, rather than traditional medical disciplines.
Doing so enabled a more patient-centred approach, taking a more holistic view of their treatment and the costs involved in each element of this.
The Cleveland Clinic has now expanded into the UK, having opened in London, where it has a number of areas which focus on value-based principles such as:
- A multidisciplinary approach;
- Standardised care protocols;
- Measurement of patient outcomes to optimise resource utilisation and enhance overall quality of care.
Santeon Group, in the Netherlands, is a consortium of seven independent hospitals which formed a co-operative to work together on quality improvements.
These focused on achieving better outcomes for patients, reporting transparently between them on what was being achieved and, in time, expanding the programme to 16 improvement programs.
It adopted an approach consisting of four elements:
1. A multidisciplinary team to define the right metrics to improve outcomes;
2. To share and learn internally, and then initiate a strict and simultaneous cadence of improvement cycles within the member hospitals;
3. After a few internal cycles to validate and stabilise the process and data, share results externally to accelerate improvements;
4. Engage with patients and payers to move toward value-based contracting.
Through the focus on value and transparency as its strategy, Santeon achieved reductions of nearly 30% in unnecessary inpatient stays and up to 74% in the rate of re-operation due to complications in breast cancer patients in a year and a half.
Lambeth, London. A contractual alliance was formed between mental health and local public health/council providers and payers – both NHS and independent – across a borough in London.
The aim was to focus on patient-centred outcomes and value-based rewards and move away from an activity-based remuneration system.
This solution included game-changing performance incentives for where providers innovated and improved the outcomes from the services in a new and significant way.
London Medical employs a multidisciplinary approach to providing tailored personal care to meet patients’ requirements, ensuring quality care through incorporating the most up-to-date clinical practices and techniques.
OneWelbeck brought together US and UK specialists to provide truly patient-centred care in one place, through situating all specialists in one place and ensuring a seamless patient experience, with consultants collaborating closely together and ensuring the application of global best practice.
And there are generally more, quality registries – clinician-led organisations which collect comprehensive data on health outcomes in patient populations experiencing the same conditions or who have had the same procedures.
These registries, used optimally, both track outcomes and serve as a basis for clinicians to work together to drive improvements and innovation in clinical practice.
What VBH can achieve
The evidence from the adoption of value-based healthcare approaches within the UK and internationally is that it can provide significant advantages for independent practitioners focused on delivering better patient outcomes.
By embracing patient-centric care, enhancing care co-ordination, emphasising prevention and wellness, aligning with value-based reimbursement, leveraging data-driven decision-making and improving professional satisfaction, independent practitioners can drive positive changes to the healthcare system while providing high-quality care to their patients
Rob McGough (right) is a partner at Hill Dickinson LLP