BackgroundWhen the commissioner of healthcare services is responsible for all health services of a certain population, the commissioner is incentivized to steer service producers towards better value (i.e. outcomes relative to costs). Value-based healthcare provides a setting for creating better value, but it is currently limited to some patient segments, not the whole population, and does not serve the purpose of steering multiple service providers with varying service portfolios and different degrees of specialization. This paper presents a tentative value-based steering model that aims to fill this gap in research and in practice.ResultsWe constructed a value-based steering model which consists of three parts: (1) the principles of steering; (2) the steering process; and (3) Value Steering Canvas, a concrete tool for steering. ConclusionsThe commissioning body can start using value-based steering without changes in legislation or the present service system.

This article aims to answer how a commissioning body can steer health services based on value in an environment where the commissioner is responsible for the health services of a population with varying health service needs. In this design science study, we constructed a value-based steering model consisting of three parts: (1) the principles of steering; (2) the steering process; and (3) Value Steering Canvas, a concrete tool for steering. The study is based on Finland, a tax-funded healthcare system, where healthcare is a public service. The results can be applied in any system where there is a commissioner and a service provider, whether they are two separate organizations or not. We conclude that steering can be done based on value. The commissioning body can start using value-based steering without changes in legislation or in the present service system. Further research is needed to test the model in practice.