Communicating Value in Our Changing Healthcare System

Recently, the Supreme Court of the United States issued a 5-4 ruling essentially upholding the entirety of the 2010 Affordable Care Act (ACA). Many Americans, including the millions working in the healthcare industry, have questions about what the SCOTUS decision means. As many of the provisions of the law come on-line in 2014, the full long-term impact is not yet clear. What is certain however is the healthcare sector is changing, fast. The shift toward more patient-centered care and measurable quality-based healthcare outcomes started prior to the 2010 law, and this movement will continue regardless of the ultimate outcome of health reform.

Moving from volume to value

In the healthcare delivery system of the past, providers were paid to treat problems, not prevent them; financial incentives were based on volume versus outcomes and multiple providers with little coordination delivered care. All of which contributed to healthcare costs rising at an unsustainable pace. Now, however, a paradigm shift is upon us.

In the idealized healthcare delivery system of tomorrow, providers are incentivized to increase quality and improve outcomes across their respective populations, infrastructure and processes are used to reduce variations and better coordinate care, and healthcare spending becomes a purposeful investment in value. Indeed, almost three-quarters (73%) of C-suite healthcare executives in a recent survey by Forbes Insights and Allscripts agreed that providers need to begin shifting their focus from “volume to value” immediately.1

The changing definition of “value”

But what does “value” mean in our brave new healthcare world? Value is one of those buzzwords flying around that has been absorbed and redefined by different stakeholders.  For patients, value means improved access to healthcare, high-quality patient-centric care, and improved patient engagement including better patient-provider communication.  For providers, value means ensuring patients receive high-quality accountable care based on best practices, including improved coordination across provider types and sites of care. Additionally, value for providers can mean receiving fair compensation—something that novel delivery systems and payment methods, including patient-centered medical homes and bundled payment schemes seek to address. For administrators, value means ensuring a sustainable healthcare system by placing particular emphasis on reducing waste, errors and redundancy.  The meaning of value in pharmaceuticals is changing as well. Now, not only are safety and efficacy evaluated, but effectiveness and appropriateness of treatment are also considered, while quality of reimbursement is downplayed. Wired health tools, such as electronic health records, are used to support treatment decisions, improve collaboration and measure behavior and outcomes.

How to communicate value now

With greater alignment across audiences, tomorrow’s healthcare delivery system demands more integrated value messages. New ways of communicating with patients and establishing value for the healthcare provider may become even more important. For example, development of safer drugs requiring less counseling, less paperwork, and drugs that have easier access to brand information could become important criteria of differentiation. Information and messages could be tailored to various HCPs and distributed in a less vertically structured environment. Outcomes research may help inform patient-centered value perspective in messages. Also, in the increasingly collaborative provider environment, the patient, her advocates, caregivers, and multidisciplinary HCP teams (social workers, MDs, RNs, NPs) may become even more important audiences to consider. This is especially true for serious diseases where care typically crosses into different disciplines and healthcare settings.

The US healthcare system is changing at a rapid pace. Still, however, the innovative delivery systems that seek to balance quality, cost and access are still in their early phases of implementation. Staying on top of these developments to identify strategic opportunity and translating insights into value-driven communication is more important now than ever before. Proactivity and adaptability will be the defining characteristics of winners on the changing healthcare landscape.

1   http://images.forbes.com/forbesinsights/StudyPDFs/AllscriptsVolumetoValue.pdf

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