Value-based Healthcare: The Challenge of Identifying and Addressing Low-value Interventions

Excerpt

The US healthcare system is the most expensive in the world on a per capita basis [24], while producing health outcomes that in many cases are in the lower 50% among Organization for Economic Co-operation and Development nations [19]. High administrative burden, misaligned financial incentives, limited transparency of costs and outcomes, and the concept of “defensive medicine” are some of the cost drivers that explain this discrepancy. Other factors, such as access issues and poor coordination of care have been blamed for poorer outcomes. Under our definition of “value”— patient-centered outcomes achieved per health care dollar spent—it is clear that there is considerable room to improve the value of US healthcare. For physicians and surgeons alike, doing so can seem like a daunting task, with many of the factors contributing to the unfavorable cost-to-outcome relationship perceived to be outside of an individual provider’s control. …