The fundamentals of value-based healthcare
In this piece, shared by the Patient Experience Agency, the ins and outs of value-based health care are explained.
Value-based health care is a global movement that has its origins in the United States and is now being adopted by over 30 countries.
It’s a response to decades of rising health care delivery costs, spiralling rates of chronic disease, changing community expectations and a desire to shift towards incentivising health practitioners based on positive care outcomes rather than volume of patients being seen.
What is value-based health care?
Value-based health care is a healthcare delivery model that prioritises the quality of care over the quantity of services provided. The goal of value-based health care is to improve patient outcomes while reducing costs, by focusing on the needs and preferences of the patient and ensuring that every medical intervention is evidence-based and necessary.
The ‘value’ in value-based health care is created when a patient’s health outcomes improve.
Five features of value-based health care
Typically, value-based health care delivery has these five leading characteristics, which make it different from how care is delivered in most practices currently:
1. Reimbursement for value, not volume
In traditional fee-for-service healthcare, healthcare providers are paid for each service they provide, regardless of the outcome. This often leads to the overuse of medical services, and in some cases, unnecessary procedures and treatments. With value-based health care, healthcare providers are reimbursed based on the value they provide to patients, rather than the volume of services they perform. This results in a more patient-centric approach to care, where providers focus on delivering the right care, at the right time, and in the right place.
2. Use of integrated data and analytics to drive decision making
One of the key principles of value-based health care is the use of patient-reported data and analytics to drive decision-making and measure success. It uses patient-reported experience and outcome measures (known as PREMs and PROMs), combined with clinical outcomes and cost data to track progress and identify areas for improvement. By using data and analytics, value-based health care aims to provide a more personalised approach to healthcare, where patients receive treatments and interventions that are tailored to their unique needs and preferences.
3. Personalised care journeys
Rather than a one-size-fits-all healthcare experience, value-based health care uses segmentation, data and analytics to group patients by like needs and provide more personalised care journeys. Patients in each segment receive treatments, interventions and experiences that are tailored to their unique needs and conditions.
4. Multidisciplinary teams and collaboration
Another key aspect of value-based health care is the use of multidisciplinary teams and collaboration. With value-based health care, healthcare providers work together across multiple specialties to provide the most effective and efficient care for patients. This often involves the use of technology and outcomes data, to help providers make informed decisions about patient care, and to share information and insights with other members of the care team.
5. Patient education and engagement
Value-based health care also prioritises patient engagement and education and encourages patients to take an active role in their own care. Patients are encouraged to ask questions, understand their options, and make informed decisions about their care. This helps to build trust and improve patient outcomes, as patients are more likely to adhere to their treatment plans and follow through with recommended care.
Is Australia adopting a value-based health care model?
Australia is in the early stages of adopting a value-based health care delivery model. The Philips 2021 Future Health Index indicated that only 13% of health care leaders here in Australia considered themselves well into their change journey towards value-based health care.
Momentum is definitely beginning to build however, with a number of major reform documents being released since 2020 which point to a future state where health care providers will be reimbursed for value and a shift to centring on delivering outcomes that matter to patients.
The strongest reform signal yet came in February 2023 with the release of the Strengthening Medicare Taskforce Report outlining the requirement to adopt a value-based care approach across all areas of the health sector in Australia in order to address the most pressing investments needed in primary care.
Value-based health care is transforming the way healthcare is delivered across the world and providing patients with the high-quality, evidence-based care they deserve. There is no doubt that change is coming to the Australian health care system and health care professionals will need to adapt to ensure their practice remains relevant and viable.
More information
For more information regarding the momentum and reform building towards the adoption of value-based health care in Australia, watch Patient Experience Agency’s free webinar: “Australian Health Reform: a guide for what it means for you and your practice”.
AD
A proud STRIDE advertiser
The case for social prescribing: what you can do (Part 2)
Workforce snapshot – what you need to know
As you are aware, the Department of Health and Aged Care has started the ambitious journey to better understand ‘scope of practice’ in the context of the primary healthcare workforce. With so many developments taking place within the Australian Podiatry Association and across the wider health sector, here is what you need to know.
How is the Australian Podiatry Association involved in the Commonwealth’s workforce activities?
In the lead up to the release of the Commonwealth’s report, Unleashing the potential of our Health Workforce, the Australian Podiatry Association (APodA) has attended numerous information sessions, roundtable events, and contributed submissions at various stages of the review.
The APodA has also created relevant member resources including this report and a scope of practice decision tree to aid decision-making; alongside drafting public-facing submissions such as this issues paper.
A key part of these activities informed the creation of APodA’s 2022 Workforce Summit which resulted in the publication of the Workforce Report. This undertaking involved 20 leaders in podiatry and other allied health professions to discuss complex workforce issues faced by the allied health sector, specifically in the context of podiatry. Rather than offer simplified solutions, the report reflects the true complexities of these issues and collates various viewpoints as a basis for onward shared learning.
Following this report’s release, a follow up snapshot report has most recently been launched by the APodA, to highlight yet more recent developments and inform future actions.
Shaping all of this is a range of workforce consultations, dataset collections and reviews driven by the Australian Health Practitioner Registration Agency (Ahpra).
Latest update
Check out the second Issues Paper which has since been published and includes more insights for podiatrists to reflect on. These issues will be explored in future communications.
Additional STRIDE resources
Reflecting on the patient experience
Podiatrist Ricky Lee was invited to trial Cemplicity’s patient experience pilot program, which was first shared in a previous issue of STRIDE. Now, at the pilot’s conclusion, Ricky reflects on his learnings to help other podiatrists who may choose to explore similar options in future.
Can you share some insights into your role and how you came to be involved with the Cemplicity pilot?
I have been involved with the Australian Podiatry Association (APodA) for many years and I have sat on regional councils, and now the Podiatry in Business special interest group. The issue of value-based health care I think will be very important for us as podiatrists, and even more importantly, as a profession.
The health care landscape is changing in this respect. I really want my team’s values to contribute to this issue; to help to map it out for fellow podiatrists.
What were the most valuable learnings you gained from this pilot experience?
This pilot provided us with an initial look at the future, regarding the depth of patient data we can access, and how this informs the future patient experience.
We know this landscape will evolve and continue to change, and this was the first step in that process. Sometimes that step can be the most daunting.
Looking back, staff education and compliance was initially difficult. Patient forms were sent out post-consult, and so maintaining staff engagement was at times challenging. However, this will become easier as we take it to the next level. Moving forward, we will directly involve staff and patients together, which will change our consult structure.
That said, we were able to get much higher compliance from patients than we first anticipated. However, without Patient Reported Outcome Measures (PROMs) it was our patients’ experience, which highlighted that our patients were very happy with their time in our clinic. If they did have a concern, it could be easily rectified. This showed that me that, from an experience measure we provide a very high level of care to our patients. Looking ahead, step two will allow us to start to look at , which will really highlight the value that podiatrists provide.
Fundamentally though, we did find reporting patients’ experiences was extremely valuable. It gave us insights into their experiences in the clinic that we would have otherwise not captured. This gave us a great place to begin this journey and it will continue to grow from this point onwards.
If there is one practical takeaway that fellow podiatrists could learn from your experience, what would it be?
It would probably be that this was certainly an easy, low-fuss way to implement experience measures. It certainly allowed us to understand first-hand what our patients thought of our service. It also allowed us to self-reflect and grow as podiatrists.
However, most practice software that is used by podiatrists allows for a set of follow-up patient questions. This approach could be more straightforward than using a separate platform. Through small amounts of research, such as sending your patients questions about their experience post-consult, you can start to implement some simple experience measures. This will allow you to reflect on your own patient outcomes, which is immeasurably helpful.
Cemplicity’s reflections
“Cemplicity’s mission is to improve the health of millions of patients. This is achieved by capturing the insights, experiences, and thoughts that can only come from the patient. This pilot aimed to enable Ricky and his team to effectively capture, understand, and act on the insights and experiences of their patients.
You can only improve what you measure. Since going live, the pilot has received over 1,200 responses from patients. These have provided valuable learnings and highlighted the amazing work each location is doing, as well as where patients believe things are great or need improvement.
The overall quality of care and net promoter score (NPS) has provided great temperature gauges around the patient experience. All comments and stories have been read and analysed by Cemplicity’s VOICE. This AI tool extracts the themes and sentiment from every comment to provide a visual tool that illustrates the volume and split of key themes. Each location can drill down into each of these patterns, to understand and act accordingly. It is the stories from patients that provide the substance to the experience ratings and the overall NPS.”
Paul Millet, Cemplicity
The Travelling Pod in Mexico: Part 1
APodA Member Insurance
Program: for podiatrists
As a podiatrist, you play a pivotal role in the health of your patients. To support you, the APodA is partnered with BMS to offer you a comprehensive member insurance program.
As an Australian podiatrist, it’s important to hold a professional indemnity insurance policy, as it’s a requirement of your Ahpra registration. While you’re not required to get insured through the Australian Podiatry Association’s (APodA) Member Insurance Program with BMS, all APodA members must have insurance while practising.
The WHS Self-Assessment Checklist: in a nutshell
This article spotlights our WHS Self-Assessment Checklist, which is available to members of the Australian Podiatry Association (APodA) by calling the APodA HR Advisory Service on 1300 620 641 or emailing hrhotline@podiatry.org.au.
This checklist serves as a practical guide, equipping businesses with the necessary knowledge and frameworks to assess, implement, and maintain robust WHS practices.
Member-only full article access available at APodA’s Human Resources Portal.
