Value-Based Healthcare From the Perspective of the Healthcare Professional: A Systematic Literature Review PMC


Supplementary Material 3 contains the full list of included studies and a summary table. A two-step screening process, comprising title and abstract screening and full-text assessment, was performed by two of the authors independently. Titles and abstracts screening resulted in eligible studies for full-text assessment. In both steps, studies were subjected to pre-defined eligibility criteria.

definition of value-based quality

For conciseness, the findings of the VBHC specific elements are summarized below. The VBHC specific elements comprised “the professional,” “the job,” and “the environment” as described from the professional’s perspective. Once performance measurements are an established part of corporate culture and managers are familiar with them, it is time to revise the compensation system.

value-based healthcare

But if I’ve coded only patients with well-controlled diabetes with E11.9, and coded those with out-of-range A1C measurements with E11.65 and so forth, then I will better understand my panel’s disease https://www.globalcloudteam.com/ burden. Diagnosis codes map to HCC codes, which factor into the RAF scores payers use to assess patient risk. Under the current HCC model, each patient’s RAF score “resets” to zero on Jan. 1.

In other payment models, the agreements establish target prices and quality metrics, including outcomes, but leave the specifics as to how those goals are achieved to those providing the care. Altogether, the aforementioned job demands, job resources and outcomes related to employee well-being and job strain show similarities with earlier research on job demands and resources in healthcare setting albeit sometimes in slightly different wording. This may imply that VBHC involves various established psychosocial factors at work and not so much radically introduces new factors that seek our attention. However, the results from this review may be too rosy as VBHC projects to date possibly focused on low-hanging fruits. Moreover, the identified factors may apply to specific VBHC components and be partly environment specific.

Values and utility in healthcare

Second, this work contributes to VBHC literature by shifting attention toward the professional. This review reveals several behaviors professionals pursue to achieve value in care, job demands and resources professionals experience in VBHC and, in turn, outcomes related to employee well-being and job strain. Related to professionals’ roles and behaviors, studies described VBHC as a bottom-up initiative that expanded roles and established new roles such as the “contact nurse” function (14, 24, 32, 56, 60–66). Engaged leadership was studied in terms of necessity, leadership approaches, competence, personal characteristics, as well as professions that were suggested to take up leadership roles . Analysis revealed 10 specific behaviors that professionals pursued in VBHC, next to acting upon their professional standards .

definition of value-based quality

This is consistent with other research findings which document that patient-physician interaction is viewed by most patients to be a highly important aspect of quality care. As previously mentioned, organizations can consider a top-guided bottom-up approach to optimally support their employees in VBHC. Within this approach, attention should be given to the pre-implementation and delivery phase of VBHC to prevent professionals from having avoidable adverse experiences. The International Labour Organisation studied frequent omissions and mistakes when implementing changes at the workplace.

Performance measurement

Once strategies for maximizing value are agreed, they must be translated into specific targets. Target setting is highly subjective, value based definition yet its importance cannot be overstated. Set targets too low, and they may be met, but performance will be mediocre.

The search string was piloted by checking whether a pre-selected set of 10 relevant studies was indeed retrieved when conducting the search, which was the case for all 10 studies. Supplementary Material 1 contains the full search string and further explanation. The search was performed on December 21, 2020 in seven databases, being Embase.com, Medline ALL Ovid., PsycINFO ALL Ovid, Web of Science (SCI-EXPANDED & SSCI), CINAHL EBSCOhost, Business Source Premier EBSCOhost and EconLit ProQuest. Data Availability StatementThe original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author. Prevention of health (through quitting smoking, dietary and lifestyle changes, exercise, etc.) reduces the need for expensive tests, procedures, and medications.


All meanings are written according to their generally accepted international interpretation. For convenience, you can use the search bar to simplify and speed up the search process. Some professionals felt obstructed to participate in VBHC and drive VBHC as a team leader .

definition of value-based quality

The search string followed the PICO statement by including keywords that describe the population, i.e., healthcare professionals, their teams or specific occupations, the intervention, i.e., VBHC, and outcomes, i.e., how the population impacts VBHC or vice versa . The goal of value-based care is to standardize healthcare processes through best practices, as in any business. Mining of data and evidence can determine which processes work and which don’t.

Using Value-based Pricing Strategies for Your Business

It also allows us to take advantage of value-based contracts that might have been out of our reach as a small, independent practice. Besides guidance for professionals, this review also supports organizations to better care for their employees and strive for a sustainable VBHC model. This review shows how organizations can use a psychosocial model such as JD-R to manage and improve employee well-being, as has been previously suggested to Human Resource Management as well . Caring for employees is besides being morally integer and beneficial for organizational performance also a legal obligation in Europe .

  • This review synthesizes insights from 45 included studies about how VBHC relates to the healthcare professional, and vice versa.
  • Adopting a value-based mindset and finding the value drivers gets you only halfway home.
  • Although work can impact professionals’ long-term performance, such as absence and intention to leave practice , we concluded from the analysis of the included studies that VBHC needs to mature before it is possible to observe long-term effects of VBHC on professionals’ performance.
  • On Question 5 patients were asked to rank 3 choices in order of importance from 1 to 3 .
  • For conciseness, the findings of the VBHC specific elements are summarized below.
  • VBHC was suggested to take more time and effort than providing lower-value care and hence was considered a job demand (31–33, 51, 62, 66, 71, 73).

Third, it develops action plans and budgets to define the steps that will be taken over the next year or so to achieve these targets. Finally, it puts performance measurement and incentive systems in place to monitor performance against targets and to encourage employees to meet their goals. A few years ago, the chief planning officer of a large company gave us a preview of a presentation intended for his chief financial officer and board of directors.

Value-Based Quality

Sixth, comparisons are impossible between countries with different economic structures and healthcare delivery systems. The term “value-based” was first introduced by a team of researcher led by Dr. Brown at the Center for Value-Based Medicine at Pennsylvania State University . The team defined VBM as “the practice of medicine incorporating the highest level of evidence-based data with the patient-perceived value conferred by healthcare interventions for the resources expended” . First, EBM principles are thoroughly selected based on the best research evidence available and applied as treatment options.

古賀 剛志

古賀 剛志




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