Column | Value-Based Payment

Has Value Become a Buzzword?

Column | Value-Based Payment

Has Value Become a Buzzword?

Our shared vision of value is at risk. We won’t attain high-value health care unless we agree on what that means.

Over the years, we’ve gone through more than our share of buzzwords in health care.

 

Buzzword has been defined as a term that’s in vogue and sounds good but that has lost its meaning as a result of overuse. Once a management approach devolves into buzzword territory, we’re on to the next big thing. Health care has seen many words consigned to the buzzword heap of history. But value must not be one of them. Delivering value to care purchasers is a fundamental principle, not a passing fad.

 

Nevertheless, the way value is being tossed around these days, some are starting to call it a buzzword. The word means different things to patients, physicians, and employers, according to researchers at the University of Utah Health. In seeking to clarify how these three stakeholder groups perceive value, they found that physicians and patients, in particular, look at value through different lenses. Out-of-pocket (OOP) costs are much more important to patients than to physicians—and even more important to patients than health improvement, the study found. A Utah researcher writing in the Feb. 27, 2018, Harvard Business Review, says: “For physicians like me, clinical outcomes are paramount … and we assume that patients share that perspective. But, it seems, they don’t. …Frankly, I was stunned by the degree of this misalignment between patients and physicians (and, by extension, the care delivery organizations the doctors work for).” The article’s title, “ We Won’t Get Value-Based Health Care Until We Agree on What ‘Value’ Means,” captures the key implication of the study findings.

 

In a report published in 2011, HFMA’s Value Project defined healthcare value for patients as encompassing four quality factors: access (which includes affordability), safety, respect, and outcomes. Looking at value through a patient’s eyes, it’s understandable if those with high-deductible health plans reduce their utilization to lower OOP costs, even at the expense of managing their chronic conditions. And looking at value though a physician’s eyes, it’s understandable if they don’t realize the extent to which reducing OOP costs is driving consumer behavior. 

 

The Utah researchers suggest a way to deal with this disconnect: “Stop, listen, and learn. The most effective thing that stakeholders can do to create a high-value health care system is to pause in their independent pursuits of value to describe to each other exactly what it is they seek.”

 

I couldn’t agree more. When I was at Spectrum Health, our Patient and Family Advisory Council (PFAC) provided a structure for talking with patients about a wide variety of issues. In a recent study conducted by the Health Care Transformation Task Force, 92 percent of healthcare organizations surveyed had some type of structure in place for engaging consumers, ranging from PFACs to website portals. Obstacles, such as lack of staff, resources, and expertise in consumer engagement, remain an ongoing challenge. But the biggest obstacle is culture change. In health care, we’re not accustomed to free and open exchanges of ideas and perspectives among patients, physicians, health system leaders, and health plans. Each group is locked into its respective role and its way of looking at the issues. We need to find ways to open lines of communication and keep them open. Together, we can build a healthcare system that reflects a shared vision of high-value health care, not an empty buzzword. 


From the President's Desk

 

Joe Fifer expands on his ideas in his April column.

Follow Joe Fifer on Twitter: @HFMAFifer

About the Author

Joseph J. Fifer, FHFMA, CPA,

is President and CEO of HFMA.

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