Champions for value-based care seek to evolve the health care system to a model that emphasizes the importance of keeping people healthy, rewards physicians for coordinating care, provides the appropriate care for each patient’s situation, and improves actual health outcomes. But value is hard to quantify and how do you choose interventions that truly improve care value in practice and not just in theory? The articles in this issue put forth potential strategies for how to deliver care that is more valuable to patients and also how to assign value to treatments from a health economics perspective.
With an estimated 16.8 million cancer survivors in the United States, methods of addressing the physical, emotional, psychosocial, and financial issues related to a cancer diagnosis and treatments are greatly needed. Deborah Christensen, MSN, APRN, and colleagues hypothesized that offering early survivorship care to patients would add greater value to their care. For this pilot study, a treatment summary and survivorship care plan were provided at the beginning of a patient’s cancer journey instead of when adjuvant therapy was complete. Additional interventions included providing patients with self-care strategies, increasing the frequency of distress screening, and conducting formal assessment of patients’ financial concerns. Based on the insights gained from conducting the study, reviewing a treatment summary and survivorship care plan at the earliest opportunity may promote patients’ understanding of their diagnosis and treatment plan thereby supporting informed decision-making. Emotional and financial issues can be addressed proactively when patients’ distress and financial concerns are assessed early in patients’ oncology care.
Cost-effectiveness analyses measure treatment value by quantifying and comparing treatment benefits, risks, and costs. Payers and policymakers often use the results of these analyses to make decisions on treatment coverage, negotiated price, and patient copayments. Thus, a key question is whether these cost-effectiveness models are fully capturing the benefits, risks, and costs of each treatment. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) has called for a broader set of value elements to be included when measuring treatment benefits and risks. Jason Shafrin, PhD, and colleagues proposed that the COVID-19 pandemic demonstrates that incorporating broader sources of value as defined in a 2018 ISPOR report is imperative for fully quantifying the value of innovation to society. In the authors’ view, COVID-19 makes clear that ill-health affects more than just health, impacting multiple aspects of society and necessitating that assessments of value capture the full spectrum of impacts on society. Furthermore, a key to ensuring that life sciences firms continue to innovate worthwhile treatments is making sure that health improvements are valued appropriately.
Finally, readers can also find a column that takes stock of where health systems fall on the road to value-based care. Richard G Stefanacci, DO, MGH, MBA, AGSF, CMD, makes the argument that there are four situational categories under which all health systems now fall on the journey toward more value-based care and away from the fee-for-service model.
