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 principal goal of the care system is to improve the value for consumers. To achieve better health care the stakeholders in this sector should focus on three important elements. The delivery of this care should be designed around the patient, payment should be based on outcomes and there should be transparency in the quality of treatment and cost. These consumers have the right to know the cost and quality of the services provided.

The care system is embracing transparency. This provides patients with the necessary information and the incentive which enables them to compare the price and quality of the many services available. This enables the patients to make an informed choice among hospitals and doctors. Providing reliable information also helps to empower consumer choice this in turn motivates the entire system to offer better care at low costs.

Consumers have adopted new strategies to counter the ever rising costs and provide them with an opportunity to benefit from their investment. They have developed a culture of health where they are able to participate actively. They monitor the behaviour and consumption of care services through the realignment of incentives. The delivery of these services is return oriented and the consumers are now working with service providers to minimize costs and better outcomes.

The idea of quality has generated a lot of confusion. In practice, quality is defined as the adherence to specified rules and regulations and the measurement is based on care process. Process measures are not effective in showing true outcomes thus providers do not get the information necessary for 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.

Healthcare value is measured in different ways depending on the type of medical care involved. The return for preventive and primary care is determined for patient groups with the same needs. A medical condition usually involves numerous specialties and therefore accountability for the return of this care is shared among all the providers involved.




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