Seeking Consensus on the Terminology of Value-Based Transformation Through use of a Delphi Process

Abstract

Collaboration among diverse stakeholders involved in the value transformation of health care requires consistent use of terminology. The objective of this study was to reach consensus definitions for the terms value-based care, value-based payment, and population health. A modified Delphi process was conducted from February 2017 to July 2017. An in-person panel meeting was followed by 3 rounds of surveys. Panelists anonymously rated individual components of definitions and full definitions on a 9-point Likert scale. Definitions were modified in an iterative process based on results of each survey round. Participants were a panel of 18 national leaders representing population health, health care delivery, academic medicine, payers, patient advocacy, and health care foundations. Main measures were survey ratings of definition components and definitions. At the conclusion of round 3, consensus was reached on the following definition for value-based payment, with 13 of 18 panelists (72.2%) assigning a high rating (7-9) and 1 of 18 (5.6%) assigning a low rating (1-3): ''Value-based payment aligns reimbursement with achievement of value-based care (health outcomes/cost) in a defined population with providers held accountable for achieving financial goals and health outcomes. Value-based payment encourages optimal care delivery, including coordination across healthcare

Value-Based Healthcare From the Perspective of the Healthcare Professional: A Systematic Literature Review

“…The exclusion criteria for all yielded studies were “not a peer-reviewed paper and/or journal,” “no empirical data,” “not part of/contributing to VBHC or synonym,” “no relation to the healthcare professional,” “only about VBHC education,” “only about value-based payment or synonym,” and “non-English.” In absence of consensus on a VBHC definition ( 4 ), we relied on the authors' judgement i.e., any study in which the original author identified the intervention as “value-based healthcare” or its synonyms was assumed to be about VBHC. We identified a healthcare professional as anyone caring for, or aiming to cure, patients or clients with a formal training to do so.…”

“…Healthcare systems increasingly move toward “value-based healthcare” (VBHC) ( 1 ), aiming to further improve quality and performance of care as well as the equitable, sustainable, and transparent use of resources ( 1 – 3 ). Thus far, a globally shared definition of VBHC is lacking ( 4 ). Yet, a characteristic shared by most VBHC programs is the multifaceted approach that, on top of clinical outcomes, provides a prominent place to patient-reported quality and performance indicators.…”

Exploring the meaning of value-based occupational therapy services from the perspectives of managers, therapists and clients

“…Defining value and translating it into service delivery is not straightforward. Various stakeholders such as clients, managers and practitioners may have differing perceptions of what value is in occupational therapy services (Porter, 2010; Schapira et al, 2020). For example, some studies have observed that while clients valued participation-based goals, occupational therapists tended to set impairment- or activity-based goals that were achievable, measurable, and in line with organisational expectations and resource constraints (Leach et al, 2010; Rosewilliam et al, 2011).…”

A Critical Review of Patient Satisfaction and Value Based Health Care

“…Healthcare systems are gradually transitioning to "value-based healthcare" (VBHC) (Porter and Teisberg, 2006), with the goal of increasing care quality and performance, as well as equitable, sustainable, and transparent resource use (Hurst et al 2022). So far, there is no generally agreed-upon definition of VBHC (Schapira et al, 2020). However, a feature shared by most VBHC programs is a multimodal strategy that, in addition to clinical results, prioritizes patient-reported quality and performance measures.…”

“…Employee well-being should be included in the imperatives of healthcare organizations, according to the early proponents of VBHC, because healthcare professionals play an important role in VBHC (Porter and Teisberg, 2006). This correlates with the quadruple goal of (Porter and Teisberg, 2006) increasing patient health outcomes, (EXPH, 2019) improving patient experience, (Hurst et al, 2022) improving healthcare professional experience, and (Schapira et al, 2020) decreasing cost (Bodenheimer and Sinsky, 2014). In comparison to normal care approaches, VBHC may have an impact on professionals' work by introducing new or shifting emphasis toward value-promoting care activities and team-based care (Bohmer, 2011).…”