Making Health Care About Health

Value-based health care: It’s become a common aspiration for organizations around the world. But what does value actually mean?

Value in health care is created by improving health outcomes for individuals and families. Living in good health is inherently less expensive than living in poor health, so better outcomes often reduce spending.

Reducing spending is important, but not sufficient to improve value. Paying less for care that doesn’t improve outcomes is not value. Rationing care is not value. The outcomes for the person being served must improve to create value.

The Value Institute for Health and Care offers a framework to support the implementation of value-based health care. It involves organizing care around defined patient segments, delivering comprehensive solutions, organizing interdisciplinary teams, and measuring results for the individuals and families who are served. We’ve also developed tools to help put this framework into practice.

Learn more about these concepts below.

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Segments

Segments are groups of individuals with shared health-related needs, such as “people with chronic migraine headaches” or “low-income frail elders.” Organizing care around patient segments—rather than around departments or specialties—allows clinicians to more effectively respond to the common needs of this particular group of patients and to personalize care.

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Solutions

Identifying the shared needs of individuals within the segment enables the design of solutions to achieve better health outcomes. These solutions go beyond traditional health care and are integrated across all facets of a patient’s life. They may address mental health, lifestyle change, or food insecurity.

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Teams

Delivering comprehensive solutions requires a variety of perspectives and skills. High-value health care organizations bring together teams from across the health care landscape—physicians and nurses as well as physical therapists, social workers, lawyers, coaches, nutritionists, and more, depending on patient needs. Teams may meet in person or virtually to ensure communication and build team relationships.

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Outcomes

To drive learning and improve health results, high-value health care teams prioritize measuring outcomes. They focus on the outcomes that matter most to patients within the segment they serve. These will vary between segments but fall into three categories: capability, comfort, and calm. Measurement helps the team share aspirations, identify improvement opportunities, and drive further innovation.