Hefti Lisa, Boëthius Hanna, Loppow Detlef, Serry Nakisa, Martin Rocio, Rupalla Katrin, Krämer Dietmar, Juchler Isabelle, Masters Caitlin, Voelter Verena
5P Health Care Solutions AG, Medical, Zürich, Switzerland.
Martini-Klinik, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Curr Med Res Opin. 2025 Jan;41(1):31-41. doi: 10.1080/03007995.2024.2433245. Epub 2024 Dec 6.
Value-Based Health Care (VBHC) represents a pivotal shift from volume-based to outcome-driven quality metrics centered on patient-valued outcomes. This approach requires collaboration across all participants in the health care value chain; providers, payers, pharma, policymakers and patients (collectively known as the 5Ps). Despite substantial theoretical endorsement of VBHC's potential for improving health outcomes and system efficiency, empirical evidence detailing its practical implementation remains limited. This field study evaluates the real-word implementation of VBHC within a health care organization.
In 2022, a health care collaboration Think Tank initiated this investigation during a breakout session, gathering insights from 12 leading international organizations to construct an empirical VBHC transformation reference guide. Real-world data was collected through structured interviews over a 1-year period, covering the 5 P value chain in various healthcare settings. The VBHC initiatives were analyzed through four stages: initiation, data acquisition, collaborative frameworks, and results evaluation.
The 12 interviews identified five key enablers for successful VBHC implementation: 1. Organizational Purpose: defining core motivators for change; 2. People: identifying pivotal roles and leadership to endorse change; 3. Resources: securing personnel and financial support; 4. Data Infrastructure: developing interoperable IT systems for effective data sharing and collection; 5. Execution: prioritizing sustained implementation processes.
The findings highlight that VBHC implementation and adoption is complex and requires incremental advancements, dedicated leadership, and resilient strategic framework spanning over multiple years. A comprehensive understanding of patient populations, risk stratification, and appropriate outcome metrics are essential to measure and deliver the VBHC transformation. Executive endorsement and transition funding during the transformation process are paramount to support this systemic shift. Collaboration among all 5 P stakeholders is essential for success. This field study underscores the importance of continuous learning and adaptation, providing a practical guide to enhance health care quality and efficiency that serves all stakeholders.
基于价值的医疗保健（VBHC）代表了从基于数量的医疗模式向以患者重视的结果为中心的结果驱动型质量指标的关键转变。这种方法需要医疗保健价值链中的所有参与者协作，包括提供者、支付方、制药公司、政策制定者和患者（统称为5P）。尽管VBHC在改善健康结果和系统效率方面的潜力得到了大量理论支持，但详细说明其实际实施情况的实证证据仍然有限。这项实地研究评估了VBHC在一家医疗保健组织中的实际实施情况。
2022年，一个医疗保健合作智囊团在一次分组讨论会上启动了这项调查，收集了12个领先国际组织的见解，以构建一份VBHC转型实证参考指南。通过为期1年的结构化访谈收集实际数据，涵盖各种医疗环境中的5P价值链。通过四个阶段对VBHC计划进行分析：启动、数据获取、协作框架和结果评估。
12次访谈确定了成功实施VBHC的五个关键推动因素：1. 组织目标：确定变革的核心动机；2. 人员：确定支持变革的关键角色和领导力；3. 资源：确保人员和财政支持；4. 数据基础设施：开发可互操作的信息技术系统，以实现有效的数据共享和收集；5. 执行：优先考虑持续的实施过程。
研究结果表明，VBHC的实施和采用是复杂的，需要逐步推进、专门的领导力以及跨越多年的弹性战略框架。全面了解患者群体、风险分层和适当的结果指标对于衡量和实现VBHC转型至关重要。转型过程中的行政支持和过渡资金对于支持这种系统性转变至关重要。所有5P利益相关者之间的协作对于成功至关重要。这项实地研究强调了持续学习和适应的重要性，并提供了一份实用指南，以提高医疗保健质量和效率，服务于所有利益相关者。
