Value-based healthcare: prerequisites and suggestions for full-fledged implementation in the Republic of Korea

Abstract

(http://creativecommons. org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Healthcare systems around the world share the common goals of improving clinical outcomes, optimizing cost reductions and efficiencies, and expanding access to care in a patient-centric manner, yet they are stymied by 2 critical challenges: wide variations in patients' clinical outcomes and soaring costs. In response to these challenges, many healthcare systems throughout the world are pivoting towards value-based healthcare (VBHC), to ultimately 1) move from volume-based to value-based care, 2) promote patient-centric care, and 3) reverse rising costs. While the United States and European nations are piloting alternative payment models, South Korea has a similar set of objectives to adopt value or performance-based payment systems. Two exemplary programs helping to move Korea towards a VBHC model are currently under way: the Support Fund Program for Care Quality Assessment and the Healthcare Benefit Appropriateness Assessment Program. However, in order to permanently establish a full-fledged VBHC system in Korea, the following prerequisites must be met: 1) normalization of provider payment rates, 2) development and dissemination of critical pathways, 3) implementation of pilot projects in the medical device sector that contain risk-share payment schemes, 4) implementation of registries to aid data-driven coverage decisions, and 5) implementation of bundled payment pilot programs for the medical conditions for which proven critical pathways already exist. Ultimately, the medical device industry is in a unique position to enhance ongoing endeavors by Korean health authorities and providers to achieve quality patient care and cost savings, all in the service of the transition to VBHC.

Analysis of Business Intelligence Applications in Healthcare Organizations

“…We found most of the problems in the HC system are because of the current approaches to managing HCOs which are not viable to cope with contemporary challenges. Hence, management systems in HCOs do not apply BI as a way to promote patient health outcomes, due to the lack of data to analyze [38].…”

Collaborating to deliver value in health care: exploring conditions required for successful healthcare and life science sector collaboration

“…Collaboration between all stakeholders; Multidisciplinary; organization from across the System, patients, patient advocates and private sector; a team-in-lead strategy; public-private partnerships; spectrum of healthcare providers; multi-sector engagement; integrated care delivery systems; collaboration with physicians, hospital systems; work together and to each-others strengths; all stakeholders to engage with medical device industry; new relationships with industry (Hara et al, 2003); (VBHC Center Europe, 2019); (Horne et al, 2019); (Malik et al, 2018); (Nishtar, 2004); ; (Beck et al, 2012); (Kaplan & Babad, 2011); (Zelmer, 2018); (Nilsson et al, 2017); (Gerecke et al, 2015); (Dafny et al, 2016); (Porter & Ishrak, 2015); (Medtronic, 2016); (Gov UK, 2016); (Martschinke & Traut, 2016); (Hu et al, 2000); (WAG, 2018); (EIU, 2016b); (Young et al, 2001); (Hurh, Ko, & Lee, 2017); (Handke et al, 2017); (Lewis (Lee, 2010) ; ; (Beck et al, 2012); (Aneurin Bevan University Health Board, 2019); (Kavanagh et al, 2012); ; (Handke et al, 2017); (Porter & Ishrak, 2015); (Neumann et al, 2011); (Wang et al, 2009); (Doyle, 2011); (Martschinke & Traut, 2016); (Miller, 2012); (Nilsson et al, 2017); (WAG, 2018); (EIU, 2016b); (Jönsson, 2009).…”

“…Infrastructure; Technologies; solving the data extraction gap; effective health information system; patient-centred mobile infrastructure; telepresence technology; build and enable information technology platforms; digital infrastructure to capture information; technology systems; health data infrastructure (Hara et al, 2003); (Patel, Pettitt, & Wilson, 2012); (Deloitte, 2018); (VBHC Center Europe, 2019); (Nishtar, 2004); (Chapman, 2014); (Beck et al, 2012); (Porter & Ishrak, 2015); (Gov UK, 2016); (Kotzbauer & Weeks, 2015); (Neumann et al, 2011) ; (Carlson et al, 2010); (Ford & Hughes, 2007); (EIU, 2016b); (Hurh et al, 2017).…”

“…The importance of a robust technology infrastructure is exemplified in the work of Kotzbauer & Weeks (2015b), where a lack of organisational competency to upgrade technology system, constituted a barrier to the implementation of VBHC payment systems, a finding which resonates with those of others (see for example Ford & Hughes, 2007;Neumann et al, 2011). It is apparent that the presence of a robust technology platform or infrastructure is important, as its absence is frequently cited as a barrier to value-based outcomes agreements (Ford & Hughes, 2007;Hurh et al, 2017;Kotzbauer & Weeks, 2015b;Porter & Ishrak, 2015).…”

“…The ability to use technology platforms to capture meaningful metrics is required to support VBHC initiatives such as bundle payments across critical pathways. A further example is the importance of the monitoring of data as evidence in risk-sharing payment for outcomes agreements (Carlson et al , 2010; Hurh et al , 2017; Neumann et al , 2011). It has been identified that there is room for improvement of health data infrastructure in most countries (EIU, 2016b), and this presents a challenge to VBHC initiatives which rely on the capture and analysis of metrics and measurements to make clinical decisions or payments.…”