Value Management in Healthcare

Our current healthcare system is broken. The Organisation for Economic Co-operation and Development (OECD) predicts healthcare costs could increase from 6% to 14% of GDP by 2060. The cause of this increase is due to (1) a global aging population, (2) growing affluence, (3) rise in chronic diseases, and (4) better-informed patients, all of which raises the demand for healthcare. In 2006, Michael Porter and Elizabeth Teisberg authored the book Redefining Health Care: Creating Value-Based Competition on Results. In it, they present their analysis of the root causes plaguing the healthcare industry and make the case for why providers, suppliers, consumers, and employers should move toward a patient-centric approach that optimizes value for patients. According to Porter, "value for patients should be the overarching principle for our broken system." Given the current state of global healthcare, there is urgency to achieve widespread adoption of this new approach. The updated second edition of this book discusses two major issues driving the importance of value-based care. The first is the emergence of artificial intelligence, which has the potential to significantly impact and enhance value-based healthcare in several ways such as delivering personalized medicine, predictive analytics for patient outcomes, and improving population health management. The second issue is why value-based care continues to struggle in scaling. While value-based healthcare has shown promise in improving patient outcomes and controlling costs, there have been challenges in implementation such as transitioning from the traditional fee-for-service model, data interoperability issues, and limited standardization of health outcomes. These challenges do not necessarily mean that value-based healthcare has failed. Instead, they highlight the complexities of the work involved and the need to follow a process as provided in this book. The intent of this book is to equip all healthcare delivery organizations with a guide for putting the value-based concept into practice. With updated material and case studies, this book defines the practice of value-based healthcare as value management. The book explores Mr. Porter's value equation (Value = Costs/Outcomes), which is central to value management, and provides a step-by-step process for how to calculate the components of this equation. On the outcomes side, the book presents the value realization framework, which translates organizational mission and strategy into a comprehensive set of performance measures and contextualizes the measures for healthcare delivery.

Nathan W. Tierney is an accomplished senior executive with over 25 years' experience of 'jumping in' into a variety of roles in multibillion-dollar public and private sector organizations to tackle multifaceted issues affecting organizations and solving time-sensitive problems by keeping things 'simple' and focused on the outcomes, while also implementing data-driven methodologies vital to any organization. Considered a global thought leader on Value Management. Veteran of U.S. Army Special Operations and recipient of our nation's highest peacetime award for heroism (1998), VA's Honor Award, and the prestigious Federal 100 Award for paving the way for the future in the development and management of information technology (2023), recipient of the Department of Veterans Affairs Secretary's Honor Award (2023) and Engage Federal Health Honoree (2024).

Preface Introduction Acknowledgments Chapter 1 Executive Summary Chapter 2 Healthcare Landscape Chapter 3 How to Measure Value Chapter 4 Value Management Office Chapter 5 Value Realization Framework Chapter 6 Steps in the Value Realization Framework Chapter 7 Outcome Metrics Chapter 8 Common Operating Picture Chapter 9 Program Core Metrics Chapter 10 Technical Metrics Chapter 11 Other Index Metrics Chapter 12 Change Management Chapter 13 Summary of Key Points Chapter 14 Has Value-Based Care Failed? Chapter 15 The Transformative Role of Artificial Intelligence (AI) in Advancing Value-Based Healthcare Chapter 16 A Father's Perspective of Type 1 Diabetes and Its Impact on His Child Chapter 17 Reflections