Concept of value-based healthcare

Abstract

This article contains the aims and main principles of the concept of value-based healthcare (VBHC). The relevance of the implementation of this approach into the Russian healthcare system results from the fact that during the control and payment for medical care, the treatment outcomes are evaluated selectively and at separate stages. The medical care payment system considers only its volumes and not achieving the desired treatment outcome significant to a patient. A review of the world’s best practices of introducing VBHC conception and, also new medical care payment methods such as bundled payment and pay-for-performance (P4P) has been conducted. According to international experience, VBHC increases the quality of medical care and provides the optimization of costs. To implement VBHC model in the Russian Federation, it is necessary to ensure the informatization of the providing medical care, development, and improvement of medical quality control systems (development of the resulting criteria for medical care quality for all diseases), and introduction of the rating system for medical organizations. Provided these processes are ensured, further progressing to P4P is possible. Moreover, it would also be feasible to implement VBHC in other healthcare processes including procurement of drugs and medical devices, their pricing, and reimbursement.

Keywords

• value-based healthcare
• value-based medicine
• pay-for-performance
• risk-sharing agreement
• patient-reported outcome measures
• patient-centered healthcare
• medical care quality control
• medical care payment