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Value in healthcare: laying the foundation for health system transformation

Insight report

27 Apr 2017

Executive Summary

The World Economic Forum, in collaboration with The Boston Consulting Group (BCG), launched the Value in Healthcare project in July 2016. This two-to-three-year multistakeholder project has four basic goals:

  • To develop a comprehensive understanding of the key components of value-based health systems
  • To draw general lessons about the effective implementation of value-based healthcare by codifying best practice at leading healthcare institutions around the world
  • To identify the potential obstacles preventing health systems from delivering better outcomes that matter to patients, and at lower cost
  • To define priorities for industry stakeholders to accelerate the adoption of value-based models for delivering care

During the first six months, the project developed a detailed taxonomy of the components of a value-based health system, prepared in-depth case studies of leading stakeholders that illustrate best practices in the field, identified some of the main barriers that hinder further adoption of valuebased healthcare, and devised a preliminary roadmap for health systems to adopt to make them truly patient-centric. The project is one of the first attempts to take a genuinely systemic approach to value-based healthcare in which all industry stakeholders have a seat at the table.

Value in Healthcare: Laying the Foundation for Health System Transformation was initially prepared as input for the Value in Healthcare project session held at the World Economic Forum Annual Meeting 2017. The report synthesizes the project’s preliminary findings, with a focus on defining the problem, developing a comprehensive framework for a value-based health system and proposing a high-level roadmap for system transformation. It also gives special emphasis to the priorities for public policy.

The paper’s key findings include the following:

  • Despite the sector’s remarkable achievements over the past century, global healthcare is marked by growing concern over its sustainability. In particular, costs are growing at roughly double the rate of growth in gross domestic product, putting severe pressure on healthcare budgets and constraining further development. – Value-based healthcare is a genuinely patient-centric way to design and manage health systems. Compared to what health systems currently provide, it has the potential to deliver substantially improved health outcomes at significantly lower cost.
  • The fundamental principle of value in healthcare is, first, to align industry stakeholders around the shared objective of improving health outcomes delivered to patients at a given cost, and then to give stakeholders the autonomy, the right tools and the accountability to pursue the most rational ways of delivering value to patients. – The value-based approach to care rests on three foundational principles: measuring systematically the health outcomes that matter to patients and the costs required to deliver those outcomes across the full cycle of care, tracking those outcomes and costs for defined population segments on an ongoing basis, and developing customized interventions to improve value for each population segment.
  • Despite considerable progress, however, no country has fully embraced value-based healthcare at the level of a national health system. Moreover, even the institutions that have taken the lead are encountering obstacles to change that are built in to how traditional health systems are organized, financed and regulated, and how financial and non-financial incentives are structured. 
  • Four enablers are key to accelerating the adoption of value-based healthcare: health informatics, to facilitate the easy collection, analysis and sharing of outcomes and cost data; benchmarking, research and tools, to leverage data on outcomes and the costs for clinical practice improvement and innovation; value-based payments, to create incentives for all stakeholders to focus on value; and innovations in organizing care delivery, to improve coordination across the health system.
  • Because healthcare is a highly regulated industry, public policy has a critical role to play in enabling the value-based transformation. Policy-makers should mandate the tracking of health outcomes and set standards for data collection, analysis and transparency. They also need to balance the trade-off between patient privacy and data sharing; enable cooperation, coordination and partnerships along care pathways while protecting against conflict of interest; establish new payment models that support improvement in patient value; and make it easier for pharmaceutical and medical technology companies to be more accountable for and contribute more actively to healthcare value. The Value in Healthcare project’s subsequent work will focus in more detail on a number of themes introduced in this initial report, including informatics, data and applications, new opportunities for clinical research, new approaches to the regulation and approval of new drugs and medical devices, and priorities for public policy.
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