The VALUE Framework: Training Residents to Provide Value-Based Care for their Patients

Patel, Mitesh S.; Davis, Matthew M.; Lypson, Monica L.

doi:10.1007/s11606-012-2076-7

Cited by 23 publications

(11 citation statements)

References 20 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several resources exist for internal medicine residency programs to implement cost-conscious care curricula, such as the High Value Care Curriculum developed by the Alliance for Academic Internal Medicine and the American College of Physicians, which is available free online. 25,28 Based on the findings of this study, medical educators should look for ways to better incorporate faculty development at their institution when implementing these curricula. Increased adoption of such curricula at a national level, along with robust evaluation and iteration of teaching and assessment methods, will be important to increase their impact on practice patterns.…”

Section: Discussionmentioning

confidence: 99%

Role-Modeling Cost-Conscious Care—A National Evaluation of Perceptions of Faculty at Teaching Hospitals in the United States

et al. 2015

Self Cite

View full text Add to dashboard Cite

BACKGROUND:Little is known about how well faculty at teaching hospitals role-model behaviors consistent with cost-conscious care. OBJECTIVE: We aimed to evaluate whether residents and program directors report that faculty at their program consistently role-model cost-conscious care, and whether the presence of a formal residency curriculum in costconscious care impacted responses. DESIGN: Cost-conscious care surveys were administered to internal medicine residents during the 2012 Internal Medicine In-Training Examination and to program directors during the 2012 Association of Program Directors in Internal Medicine Annual Survey. Respondents stated whether or not they agreed that faculty in their program consistently role-model cost-conscious care. To evaluate a more comprehensive assessment of faculty behaviors, resident responses were matched with those of the director of their residency program. A multivariate logistic regression model was fit to the outcome variable, to identify predictors of responses that faculty do consistently rolemodel cost-conscious care from residency program, resident, and program director characteristics. PARTICIPANTS: Responses from 12,623 residents (58.4 % of total sample) and 253 program directors (68.4 %) from internal medicine residency programs in the United States were included. MAIN MEASURES: The primary outcome measure was responses to questionnaires on faculty role-modeling cost-conscious care. KEY RESULTS: Among all responses in the final sample, 6,816 (54.0 %) residents and 121 (47.8 %) program directors reported that faculty in their program consistently role-model cost-conscious care. Among paired responses of residents and their program director, the proportion that both reported that faculty do consistently rolemodeled cost-conscious care was 23.0 % for programs with a formal residency curriculum in cost-conscious care, 26.3 % for programs working on a curriculum, and 23.7 % for programs without a curriculum. In the adjusted model, the presence of a formal curriculum in costconscious care did not have a significant impact on survey responses (odds ratio [OR] were not consistently role-modeling cost-conscious care. The presence of a formal residency curriculum in costconscious care did not impact responses. Future efforts should focus on placing more emphasis on faculty development and on combining curricular improvements with institutional interventions to adapt the training environment.

show abstract

Section: Discussionmentioning

confidence: 99%

Role-Modeling Cost-Conscious Care—A National Evaluation of Perceptions of Faculty at Teaching Hospitals in the United States

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our work offers an oncologist perspective to the growing clinician voice that willingness to discuss costs is consistent with patient-centered care [28,29] and may be an ethical imperative [30,31]. Cost-consciousness is increasingly included as a competency of medical training [32,33]. …”

Section: Discussionmentioning

confidence: 99%

Patient and oncologist discussions about cancer care costs

Henrikson

Tuzzio

Loggers

et al. 2013

Support Care Cancer

View full text Add to dashboard Cite

Purpose Patient out of pocket costs are higher for cancer care than for any other health care sector. Oncologist-patient discussions of costs are not well understood. We conducted an exploratory interview study to examine the frequency, patterns, attitudes, and preferences of both patients and providers on discussion of treatment costs. Methods We conducted semi-structured telephone interviews with oncology clinicians and people receiving chemotherapy at a large nonprofit health system. Multiple investigators conducted thematic analysis using modified content analysis, grounded theory, and interaction analysis methods. Results Patient themes included the relevance of cost to their experience, preference for the doctor to be the starting point of cost discussions, but relative infrequency of discussions with doctors or other care team member. Provider themes were an emphasis on clinical benefit above costs, conviction that cost-related decisions should rest with patients, and lack of access to treatment costs. Interest in discussing costs and barriers accessing cost information were common themes from both patients and providers. Conclusions Doctors and patients want to discuss treatment costs but lack access to them. These data support growing evidence for a provider role in discussions of cost during cancer treatment planning.

show abstract

“…Several models for training residents in high-value, costconscious care have been proposed. 5,6 If GME is going to play a significant role in curtailing the rising cost of health care, it must leverage such models to develop more robust teaching and assessment methods and provide faculty development. Programs that have already implemented such curricula should rigorously study its impact on resident and faculty behavior to inform adoption at other institutions.…”

mentioning

confidence: 99%