As we shift more to value-based care, we must create models that not only deliver on the value proposition of increased quality and service at a lower cost, but also are models that are sustainable. We need to think about models within a larger health ecosystem. This ecosystem has many components, and collaboration will be needed as there is no one single solution.
Sustainability will require continued focus on the consumer. But since there is not a “true” healthcare consumer in the traditional sense, as no one goes out to purchase healthcare because they want to, successful models will need to address this basic fact. There are consumers of healthcare, and thus sustainability will require a steadfast approach to making sure the consumer stays at the center. We will not have success if our focus is on how to make things work for the supplier of services. The consumer needs transparency of both information and cost. Activation, engagement, and education are musts in a consumer-focused environment.
Those that are focused on creating value-based care must realize we are working within an industry that is unpredictable. The nature of illness in itself is the most unpredictable variable. We cannot predict who will need what when. The best way to handle this is to remain adaptable. Adaptability will require continuous learning and adoption of new ways of thinking. The healthcare industry has historically been very poor at thinking of itself as a learning body.
Financially, in a private sector model, companies and providers of healthcare need to expect and receive a moderate return on their investments. Business principles will not allow for innovation and learnings if there is not a likelihood of success. Only through innovation will we continuously improve on both what and how care is delivered. If there is too much unpredictability concerning financial stability, there will be much less private sector influence on the movement to value. The result of this could lead to greater governmental intervention, which might be beneficial in certain ways, but likely less progressive in other ways.
Common outcomes, metrics, and intra-operability of our technology systems are needed to avoid continued fragmentation. Having defined common definitions of what success looks like is a requirement. The ability for the healthcare technology infrastructure to communicate concerning the needs of those we serve is paramount to providing value. Transparency of outcomes will create a much more consumer-driven environment.
Though the focus of a consumer-driven model is usually on the individual, we also must think about societal value. Individuals are relational by nature and live within communities. An individual has an obligation to their community just as the community has an obligation to the individual. Longevity of any value-based care approach will require constant focus on both improving the health of individuals and the communities in which they live. There is a tight integration between the two, which goes beyond just the delivery of healthcare. There are many health determinants that will require a societal approach to solving that should not be outside the scope of the healthcare system. Solving for both the clinical and non-clinical determinants of health will create greater health and well-being for all.