Value-Based Health Care
What is Value-Based Health Care (VBHC)
Value-Based Health Care is an approach focused on achieving health outcomes that matter most to patients and families across the full cycle of care, relative to the cost of delivering that care. Value-Based Health Care drives us to understand what’s important to patients, how effective we are at improving their lives, and what care provides the best outcomes for the money we spend.
Measuring outcomes relative to the cost of providing care is a key principle of Value-Based Health Care. Teams work together and with patients measuring outcomes, addressing gaps in care, adjusting processes and services, learning and identifying improvements, and over time understanding which care provides the best outcomes for the money we’re spending.
When we improve people’s outcomes, they live with better health and require less care, and that makes our health care system more sustainable. After all, it costs less to live in good health, than in poor health.
What are Health Outcomes
For patients, health outcomes that matter most focus on being able to do the things that ‘let me be me’, relieving suffering and letting people live their best lives while getting care. As care providers, this is what we want for patients too.
Health outcomes that matter tend to be similar within a patient group who share a medical condition, for example ‘shoulder pain’, or ‘adults with Type 1/2 Diabetes’. Organizing care around a patient group with a shared medical condition is different to how we’re organized today, which is often by provider specialty or intervention (e.g. orthopedic surgery).
Ideally, outcomes are defined by patients - not by us. This might involve using or adapting an existing patient-centred outcome data set, like those developed by ICHOM. Or, it may involve engaging Providence patients in experience groups to understand what matters to them as representatives of their specific patient group. Once the health outcomes that matter are identified for a patient group, they’re measured for each individual patient during their care journey.
Teams who care for a specific patient group over the full care journey will work together measuring the same outcomes. Interdisciplinary teams of clinical and non-clinical staff and medical staff may come together physically or virtually, and sometimes as formalized Integrated Practice Units.
Value-Based Health Care + Integrated Practice Units (IPUs)
Another important term you'll hear about is Integrated Practice Units or IPU. IPUs are multidisciplinary teams that are structured to meet the needs of well-defined groups of patients over the full cycle of care. Although it may not seem that different than what we do now, these teams are organized more specifically around the needs of patients (such as those experiencing back pain), rather than around a physical structure (e.g., hospital ward) or particular intervention (e.g., spine surgery).
Within a Program there may be a few or many IPUs. There will also be IPUs that cross different Programs.
Questions? Connect with us at VBHC@providencehealth.bc.ca