Linking Employee and Organizational Health
Edited by Ronald J. Burke and Astrid M. Richardsen
Chapter 7: Value-based healthcare for employers
American employers will be looking forward to another year of rising healthcare costs for their employees and dependents. Despite countless incremental solutions such as wellness programs, consumer-driven healthcare, and provider payment reform, there has been very little impact on both the quality and the price of healthcare for employers. It is time for a fundamental new strategy. At its core is a need to maximize value for patients – ‘value-based healthcare’. Value-based care delivers the best outcomes at the lowest cost. And every stakeholder has a role to play including employees, employers, benefit consultants, providers, health plans, and innovative healthcare vendors. So what is the primary goal of value-based healthcare? To date, healthcare reform strategies have been hampered by lack of clarity in defining this goal. Limited goals such as discounted fee for service pricing or improving access to care have not delivered the proper results. Neither improving access to poor care nor reducing the cost at the expense of quality are desired objectives. In healthcare, the primary goal must be improving the health value to patients, where the health value is defined as the patient outcomes achieved divided by the cost of achieving those outcomes. Furthermore, these outcomes must be defined by what matters most for patients. Improving value occurs by either improving outcomes or reducing costs or ideally both.
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