INTRODUCTION TO VALUE-BASED MEDICINE
Health care spending in the U.S. is on an unsustainable trajectory, with nearly 18% of its GDP spent on health care in 2021—nearly twice as much as comparable industrialized countries. And yet, the U.S. also routinely ranks at the bottom in health outcomes when compared to other high-income countries. Compared to those in peer countries, Americans are more likely to die at a younger age, and from avoidable causes.
We are overdue for a fundamental transformation in how we deliver care, from a fee-for-service system that rewards doing—more tests, more procedures, more interventions—to one centered around value, in which health care providers are responsible for delivering good outcomes efficiently.
Value can be defined as outcomes that matter to patients over the costs associated with delivering those outcomes. VBM puts patients at the center—the goal is delivering outcomes that matter to patients, not health care providers or health systems, and doing so in a way that is most cost-effective so as to serve the greatest number of patients. VBM is about reducing unnecessary care while performing more necessary care.
For providers, VBM promises a better way of practicing; the model is centered around multidisciplinary teams in which all members work at the top of the licenses. Physicians can spend more time on what they are trained to do, and less time on administrative tasks or services they are less well-trained to perform. VBM has been described as a potential antidote to physician burnout, which is considered a consequence of moral injury in being unable to provide the care that patients need, often due to deficiencies in the current health care system.
“At the most fundamental level, better quality lowers cost in health care because better health is inherently less expensive.” — Porter & Teisberg, “Redefining Health Care”
We strongly believe that VBM is the future of health care, and as such, it is critical for medical trainees to be engaged with VBM principles early on and develop practice patterns that are in line with maximizing value. Despite this, there is little to no time dedicated to training on topics of health care management and financing in undergraduate medical education. The HealthValueLab is dedicated to developing and disseminating tools and resources for medical students to develop a practical understanding of VBM, and empower them to take an active role in conversations around care delivery and resource stewardship. The Value Calculator was designed to provide transparency on costs, particularly in the context of interactive cases that place users in the mindset of an ordering physician. As we continue to build out the HealthValueLab, we hope to eventually include hospital-specific pricing data, data visualizations, and more advanced cases for clinical students.
LEARN MORE ABOUT VBM
Dell Medical School’s Value-Based Health Care Interactive Learning Modules are a fantastic resource and provide a comprehensive introduction to VBM. We highly recommend starting here if you are interested in learning more.
What Is Value in Health Care? (Michael Porter)
The Strategy That Will Fix Health Care (Michael Porter and Thomas Lee)
Overkill (Atul Gawande)
The Cost Conundrum (Atul Gawande)