Dive Brief:
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A new report, prepared by The Economist Intelligence Unit (EIU) and sponsored by Medtronic, offers lessons learned from efforts toward value-based healthcare (VBHC) in 25 countries around the world, providing a common framework and examples of successful implementation.
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The report includes an in-depth look at how policies and technologies will factor into the transformation.
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Researchers rated U.S. alignment with VBHC principles as moderate. Sweden and the UK were the furthest ahead with respective ratings of "very high" and "high."
Dive Insight:
While the U.S. is considered to be among the frontier countries in implementing VBHC, it faces many of the same challenges as other countries, with piecemeal advances often held back by entrenched interests and practices, as well as legacy infrastructure and IT systems that are not interoperable.
"Value-based care plays a small role in U.S. healthcare, but pockets of value-based innovations are emerging across the system," the analysis found, calling out CMS for driving much of the change.
Indeed, earlier this year HHS announced it had achieved its goal ahead of schedule of tying 30% of Medicare payments to alternative payment models that value healthcare quality over quantity.
While mature economies struggle with shifting their status quo from fee-based arrangements, developing ones are struggling to leapfrog directly into establishing health systems based on value. The authors highlight that strong policy support is more often found in wealthier countries, and that of the seven countries with a high-level policy or plan to implement VBHC, just two—Turkey and Colombia—are developing countries.
The U.S. could take a point from the report's finding that we have not just moderate alignment with VBHC principles, but also just moderate "enabling context, policy and institutions."
That is despite the fact that countries' overall health expenditure was shown to be a strong indicator of their ability to move toward value-based care, which suggests we could potentially do better. The report points to the fact that among the countries that spend more than 10% of their GDP on healthcare, the U.S. and Japan are notable for not having a recognized national health technology assessment (HTA) organization, which it identifies as an enabling component for value-based decision-making.
One of the aspects for which the U.S. is called out in the report is for its moves toward bundled payments, which researchers found to be in use by at least one payer in six of the 25 countries evaluated.
Currently, Europe is leading the global movement toward VBHC principles. The researchers note budget constraints to be the main driver in Europe’s push, while increasing healthcare costs are the driver in the U.S.