The Australian Centre for Value-Based Health Care is developing a research program to explore issues relating to value-based health care in the Australian context. For information on how you can contribute to this research program contact us here.
HEALTH POLICY BRIEFS
Published by the Deeble Institute for Health Policy Research Health Policy Briefs are short, easy to read, objective papers that synthesise the research evidence in an area of health policy. They are designed to help policymakers who need to quickly find out what evidence exists in a topic area, how compelling it is, and what the implications might be when using it to develop health policies. They also provide a list of key readings for those who need to know more.
Included here are briefs with relevance to value-based health care. A full list of briefs published by the Deeble Institute for Health Policy Research can be found on its website at https://ahha.asn.au/deebleinstitute
A growing number of healthcare organisations are embarking on a Value-Based Healthcare (VBHC) journey, and research exploring success factors to implementation provides encouraging insights. As Australia considers the potential of VBHC as a new direction in the delivery of its healthcare and funding, understanding the implementation landscape is a critical step.
By consulting with key opinion leaders from seven countries, this paper attempts to understand the factors that are likely to contribute to the success of VBHC implementation in Australia.
The COVID-19 pandemic has dominated all sectors of Australian life – testing state and national policies, brought healthcare to the top of national priorities, and led to quick adoption of strategies and practices to protect vulnerable populations. At the outset of the pandemic, telehealth was widely embraced by policy makers, healthcare providers and patients to facilitate consultations, patient monitoring, communication and continuity of care, and minimise the risk of infection.
In the provision of cancer care, numerous changes have been recommended and implemented to variable degrees. These include modification of treatment pathways (change in therapy, delay, or omission), postponement of clinical trials, and delay in timely diagnosis, including suspension of screening programs. These changes were implemented to protect patients with malignancies, who are considered to be a higher risk group for developing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with resultant poorer outcomes than the general population. Emerging data show that the diagnostic and treatment delays resulting from the suspension or reduction in health services will lead to substantial increase in the number of avoidable cancer deaths. Effective use of telehealth can reduce these adverse outcomes and close gaps in patient access to care.
Moving forward, the combination of the need for innovative strategies within the more stringent economic conditions we face, means improving value in healthcare has become paramount. It is, therefore, important to learn from our experiences within this global crisis and ensure that valuable lessons are implemented in future policy, particularly to guide the delivery of patient-centred, value-based healthcare.
Value-based healthcare is a model for the design, delivery, funding, reporting and evaluation of health services, which aims to maximise improvements in patient outcomes of care relative to cost.
Dental Health Services Victoria (DHSV) has successfully implemented a novel value-based healthcare model, co-designed with patients in the public dental sector. DHSV’s value-based healthcare model offers the highest recognition of what patient’s value while defining health and care outcomes and how this can be achieved in a public dental setting with limited available resources.
This Perspectives Brief from the Deeble Institute for Health Policy Research, authored by Dr Kate Raymond and Dr Shalika Hegde (DHSV) maps the experience of organisational change, and the important contextual enablers which facilitated service reform, from the perspective of DHSV’s organisational leaders on a journey to value-based Healthcare.
Deeble Perspectives Brief No. 5, written by a research team led by Professor Christobel Saunders from the University of Western Australia, reflects lessons learned from implementing a value-based healthcare initiative, the Continuous Improvement in Care–Cancer (CIC Cancer) Project. The project seeks to bring value-based healthcare principles to cancer management in private and public healthcare settings in Western Australia. Professor Saunders said that through experiences so far with the CIC Cancer project, the research team had learned some valuable lessons in four main areas: planning and governance; engagement and expectation management; data issues; and information technology systems.Perspectives Brief No. 5: Toward value based care: Lessons learnt from implementing outcomes measures
Sustainability is a complex, multifaceted concept that continues to evolve depending on the perspectives of different sectors and professions and their respective expertise and interests. Fundamental in all conceptualisations, though, is the challenge to shift thinking away from humans and nature being separate in the world, and their activities and effects being compartmentalised.
Transforming the health system for sustainability requires consideration of the systemic and complex nature of climate change as a determinant of health, for today’s and future generations. This will require attention to both patient level processes and different framework requirements at each level of the health system.
The strategic framework for value-based health care transformation provides a guide for supporting the consideration of climate change and its impacts on health and health care.
In Australia, the immediate urgency of responding to the pandemic and the pressing need to respond operationally has moved attention away from health system reform. This situation will not persist indefinitely, and Australian governments should now consider an effective and proportionate value-based response to COVID-19, Long COVID and its other longer-term consequences, that considers both patient health outcomes and costs.
Evidence-based studies with a focus on clinical outcomes are vital as is cost benefit analysis, but this must be enhanced with data on patient outcomes and experiences in order to fully assess the value of the investment.
The creation of a robotic surgery program at Metro North Hospital and Health Service in Queensland provides an example of how robotic surgery for hip and knee replacements was assessed and implemented in a major metropolitan public hospital.
Deeble Issues Brief No. 37: New technology and VBHC
Deeble Issues brief No. 37: New technology and VBHC summary
Recommendations are provided to support the achievement of greater public value for health investment as hospitals, health services and governments implement value-based health care reforms.
See summary and brief here
The Commonwealth Government’s Long-Term National Health Plan includes commitments to support flexible care models that do not rely on fee for service, as well as the development of a national preventative health strategy. However, without clear policy levers to measure and fund meaningful improvements in health outcomes, national efforts to achieve a vision of ‘a mentally and physically healthy Australia’ are likely to be hampered.
Deeble Issues Brief No. 33: Reforming for value opportunites for outcome focused national health policy
Deeble Issues Brief No.33: Reforming for value opportunities for outcomes focussed national health policy summary
Deeble Issues Brief No. 32: focusses on funding reforms that will be required to achieve value‑based health care for public dental health in Australia. Using Dental Health Service Victoria’s learnings from a value-based health care implementation and funding model reform, this Issues Brief draws on local and international examples that provide the rationale and evidence for funding reforms that maximise value and outcomes for patients, funders and the health system.Deeble Issues Brief No. 32: Re-orienting funding from volume to value in public dental services: Summary
A value-based approach to health care provides a patient-centric way to design and manage health systems. This Issues Brief considers Australia’s alignment with a value-based approach and identifies important enablers that are already present, but outside a coordinated national strategy. The Brief also examines international evidence, while recognising the need for building evidence in the Australian context where value must be considered in the context of universal health care and our health system. Recommendations are made for enabling value-based health care through public policy in Australia.Deeble Issues Brief No. 31: Value Based Health Care: 2 page summary
Accreditation is a process of external peer review to assess the performance of a healthcare facility in relation to agreed healthcare accreditation standards. In Australia, the requirement is mandatory accreditation against the Australian National Safety and Quality Health Service (NSQHS) Standards.
This Health Policy Evidence Brief from the Deeble Institute for Health Policy Research and the Australian Council on Healthcare Standards (ACHS) adopts the Quadruple Aim framework to assess the value of accreditation to health services.
The brief calls for the need to develop a research-based approach to develop a common narrative on what constitutes value, so that value relating to interventions such as accreditation can be more appropriately assessed.Evidence Brief No.18 Assessing the value of accreditation