BOX 8-1Value in Health Care: Common Themes

  • Urgency: The urgency to achieve greater value from health care is clear and compelling.
  • Perceptions: Value means different things to different stakeholders, so clarity of concepts is key.
  • Elements: Identifying value in health care is more than simply the right care for the right price.
  • Basics: Improving value requires reliable information, sound decision principles, and appropriate incentives.
  • Decisions: Sound decision principles center on the patient, evidence, context, transparency, and learning.
  • Information: Information reliability derives from its sources, methods, transparency, interpretation, and clarity.
  • Incentives: Appropriate incentives direct attention and rewards to outcomes, quality, and cost.
  • Limits: The ability to attain system value is likely inversely related to the level of system fragmentation.
  • Communication: System-level value improvement requires more seamless communication among components.
  • Providers: Provider-level value improvement efforts depend on culture and rewards focused on outcomes.
  • Patients: Patient-level value improvement stems from quality, communication, information, and transparency.
  • Manufacturers: Manufacturer-level regulatory and purchasing incentives can be better oriented to value added.
  • Tools: Continually improving value requires better tools to assess both costs and benefits in health care.
  • Opportunities: Health system reform is essential to improve value returned, but steps can be taken now.

From: 8, Common Themes and Opportunities for Action

Cover of Value in Health Care
Value in Health Care: Accounting for Cost, Quality, Safety, Outcomes, and Innovation.
Institute of Medicine (US) Roundtable on Value & Science-Driven Health Care; Yong PL, Olsen LA, McGinnis JM, editors.
Washington (DC): National Academies Press (US); 2010.
Copyright © 2010, National Academy of Sciences.

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