Key Success in The Transformation from Volume-Based to Value-Based Healthcare: A Scoping Review

Abstract

The medical cost trend had been increasing faster than the global inflation rate. Higher costs posed a significant problem for healthcare providers, payers, and eventually patients. The concept of value-based healthcare (VBHC), which emphasized the importance of measuring outcomes relative to the costs, was introduced to mitigate the impact of these medical trends. This research used a scoping review methodology to describe the factors that affect the shift from the conventional volume-based healthcare to value-based healthcare. Data of research based on article search was conducted using online Scopus and Embase databases, resulting in 800 articles describing value-based healthcare. Duplication removal excluded 76 articles, screening excluded 295 articles, eligibility assessment excluded 76 articles, and the remaining 30 articles were included. The results of study show that VBHC was proposed as a shift in healthcare management entailing six reinforcing elements, but most hospitals have implemented only one VBHC element. The most common implemented elements are “the measurement of outcome and cost” and “the reorganization to integrated practice units.” The key success for the implementation of these elements are: (1) strong data collection to measure clinical outcomes that matter to patients, (2) clear governance of this data management, and (3) strong support from the high leadership to encourage multidisciplinary teamwork. Thus, the true VBHC system can only be reached when all the six elements are achieved. However, no single study describes a success in implementing all elements of VBHC. Hospital leaders need to be cautious when interpreting VBHC as not to think that the VBHC can be reached by cherry-picking only selected elements of VBHC.

Psychosocial factors contributing to value creation in value-based healthcare: a scoping review

“…However, evaluating value solely based on costs is insufficient. According to a scoping review by Gunawan et al (2022) , most implementations of VBHC focus only on outcomes and costs, neglecting its multidimensional nature. None of the studies reported complete success in applying all aspects of VBHC.…”

“…None of the studies reported complete success in applying all aspects of VBHC. Therefore, hospital leaders need to understand that VBHC adoption involves more than just partial implementation ( Gunawan et al, 2022 ). While traditional discussions of VBHC have emphasized its economic aspects, as noted by Kim et al (2013) and Kaplan and Porter (2011) , recent literature suggests the need to explore its psychosocial dimensions ( van Engen et al, 2022 ).…”

“…Such an approach can potentially improve patient outcomes, the well-being of healthcare workers and organizational culture ( Capone, 2022 ; Marino and Capone, 2023 ). In summary, despite the increasing adoption of VBHC ( Gunawan et al, 2022 ), defining, measuring and understanding the value of healthcare is a challenging task that requires the inclusion of psychosocial dimensions and consideration of the common matrix of social and economic issues ( Osei-Frimpong, 2016 ). This scoping review aims to highlight the psychosocial dimensions of VBHC by describing the potential psychosocial factors that contribute to value creation in healthcare, with a consequent reduction in costs and considerable advantages for the management, also economic, of health and public health organization.…”

Health outcomes measurement for value-based healthcare

“…In addition, the VBHC model emphasizes patientcentered approaches by placing the patients at the center of the healthcare process, involving them in shared decision-making, and prioritizing their preferences, values, needs, and outcomes (Hillary et al, 2016). These positive attributes of VBHC have led many healthcare organizations to start a transformation journey toward VBHC delivery systems, with "value" measurement being the first and foremost step in this transformation (Gunawan et al, 2022).…”