Public hospital buildings in Malaysia have been facing problems and have become subjects of public criticisms due to poor building maintenance practices. A value-based approach which integrates and assimilates the concepts of value can be applied to mitigate maintenance problems in hospital buildings. This study evaluated the causal relationships between value factors and value outcomes of building maintenance in public hospitals in Malaysia. A total of 66 samples were collected via an online questionnaire survey. Analysis was performed using partial least square structural equation modeling (PLS-SEM). Our results reveal that value-adding practices and value co-creation have a positive influence on value outcomes in hospitals. The findings, however, do not support the relationships between factors of user involvement and value outcomes, which merit further investigation. This study concludes that value-adding practice has the strongest impact on value outcomes. Thus, maintenance service providers should assimilate these practices in their services to enhance performance. In addition, the findings also justify the requirement for collaborative working arrangements for value co-creation of building maintenance.