What Healthcare Value Is All About

By Maryellen Lamb


The healthcare value for a given patient is determined by the outcomes of the patient per dollar spent. Information on this factor is essential in improving the delivery of health care services. It helps to improve the entire process, aids in restructuring of the care system and also supports the implementation of new reimbursement and outcomes approaches that are very cost effective. Senior leaders from numerous care organizations have come together to deliberate on how to handle cost measurement and outcomes

The healthcare system aims at improving the value for patients. To improve the services offered in the care system the providers have to focus on three key factors. The delivery of care needs to be centered on the patient, payments for these services should be made with respect to the outcomes and transparency in treatment cost and quality should be emphasized. The consumers should be provided with adequate information on the cost and nature of the services available.

Transparency is becoming a major factor in the care system. This has allowed customers access to adequate information which has enabled them to make comparisons of the prices and quality of services offered by the different providers. The patients are now able to make informed choices. The provision of reliable information has further empowered customer consumer choice and revolutionized the entire system.

Consumers have come up with new mechanisms to ensure they are able to benefit from their healthcare investment. These mechanisms counter the ever growing costs of the services offered. Some of these mechanisms include the creation of a culture of health in which they have an active role. The incentives have been realigned to improve health behaviour and to control the consumption of medical care. The delivery of services is based on the quality and they are also working closely with providers to reduce costs and achieve better outcomes.

The measurement of quality has been a big challenge in this sector and has created a lot of confusion. Essentially, quality is the strict adherence to specific guidelines and its measurement mainly focuses on care processes. Process measures do not give a clear indication of the outcomes which denies providers the data they need to make any significant innovation.

The failure to prioritize improvement of returns in the delivery of care services and to measure it has hindered innovation in this sector and led to poor methods of management which have led to increased costs. The measurement allows for reforms to the reimbursement system to provide bundled payments covering chronic conditions, full care cycle or periods of several years. It is important for providers to align reimbursement with value for them to be able to achieve good outcomes and also be able to account for substandard care.

There are very many stakeholders that participate in the provision of medical services. It is not possible to identify a single one of them and use it to create a standard for measuring this return. An appropriate unit for determining this return should take into account all the services involved in the satisfaction of the needs of a customer. The medical condition of a particular patient determines his or her needs.

There are numerous ways of measuring healthcare value. These methods depend on the nature of medical care involved. To determine the value for preventive and primary care a group of patients with similar needs is studied. For medical conditions involving many providers the value is shared among them.




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