Articulate the meaning of value Value proposition in patient care

Value proposition in patient care

Articulate the meaning of value-added service as it pertains to patient care services, and argue the major reasons why it matters to add value to patient services. Justify your response.

Responsible reform for the Middle Class stated, The Patient Protection and Affordable Care Act will ensure that all Americans have excess to quality, affordable health care and will create the transformation within the health care system necessary to contain costs. One part of the transformation is the creation of the value proposition. Value proposition is the promise of the value to deliver to the patients with possible services. Value is defined as “a fair return or equivalent in goods, services and money for something exchanged; the monetary worth of something; market price; or the relative worth, utility, or importance (Merriam-Webster 2010).” In healthcare, value is measured by the outcomes achieved, not the volume of services delivered without the improved quality and nor measure by the process of care used.

Value can be seen a mathematical equation. Outcomes are the numerator of the value equation. The outcomes are perceived as the real measures of quality. Outcomes measurement focuses on the immediate results of the particular procedures or interventions, rather than the full care cycle for medical condition or preventive care. Cost is the denominator. It refers to the total cost of the entire cycle of care for the patient’s medical condition. Best approach is to spend more money on some services to decrease the need for others.

An example of why value added services matters to the healthcare system is because the value should be about the patients, and no longer it should be about how many patients a physician can see, how many tests and procedures a physician can order. Today’s value-added services cover a wide scope. They can be as simple as lifestyle management programs that encourage people to participate in exercise protocols intended to help manage symptoms of RA, or as complex as hands-on, day-to-day management of hepatitis C patients so that they take their prescribed dose of antiviral medications.

Although their working mechanisms may be very different, the promise of every proposed value-added service is simple: improve patient outcomes and, consequently, save money. But the primary question surrounding them remains as complex as ever: Which value-added services truly add value — and which are merely marketing?

“Most value-added services are centered around one of two concepts — cost or convenience,” says Judi Grupp, president of ActiveCare Network, a provider of vaccine, injection, and infusion services throughout the United States. “When you have chronic patients you are trying to manage over long periods of time, you want not only patient-reported data, which can be very subjective, but also clinical data that show whether the drug is working like it’s supposed to. Health plans … don’t mind covering a biologic if it does what it is supposed to do, but they need data to help make that decision. More and more frequently, that’s what we’re asked to provide.”

Outline a system for identifying the functional areas in which changes might be necessary in order to improve the hospital’s service value. Recommend the key methods that you would use to acquire the information necessary to identify the specified functional areas.

Health care delivery involves numerous organizational units, ranging from hospitals to physicians’ practices to units providing single services, but none of these reflect the boundaries within which value is truly created. The proper unit for measuring value should encompass all services or activities that jointly determine success in meeting a set of patient needs. These needs are determined by the patient’s medical condition, defined as an interrelated set of medical circumstances that are best addressed in an integrated way. The definition of a medical condition includes the most common associated conditions — meaning that care for diabetes, for example, must integrate care for conditions such as hypertension, renal disease, retinal disease, and vascular disease and that value should be measured for everything included in that care.

For primary and preventive care, value should be measured for defined patient groups with similar needs. Patient populations requiring different bundles of primary and preventive care services might include, for example, healthy children, healthy adults, and patients with a single chronic disease, frail elderly people, and patients with multiple chronic conditions.

Care for a medical condition (or a patient population) usually involves multiple specialties and numerous interventions. Value for the patient is created by providers’ combined efforts over the full cycle of care. The benefits of any one intervention for ultimate outcomes will depend on the effectiveness of other interventions throughout the care cycle.

Accountability for value should be shared among the providers involved. Thus, rather than “focused factories” concentrating on narrow groups of interventions, we need integrated practice units that are accountable for the total care for a medical condition and its complications.Because care activities are interdependent, value for patients is often revealed only over time and is manifested in longer-term outcomes such as sustainable recovery, need for ongoing interventions, or occurrences of treatment-induced illnesses. The only way to accurately measure value, then, is to track patient outcomes and costs longitudinally.

For patients with multiple medical conditions, value should be measured for each condition, with the presence of the other conditions used for risk adjustment. This approach allows for relevant comparisons among patients’ results, including comparisons of providers’ ability to care for patients with complex conditions.

Specify four (4) specific areas where you believe the administration can add value in Paradise Hospital, and argue the most significant reasons why such value proposition would improve the value of services to the patients.

The current organizational structure and information systems of health care delivery make it challenging to measure (and deliver) value. Thus, most providers fail to do so. Providers tend to measure only what they directly control in a particular intervention and what is easily measured, rather than what matters for outcomes. For example, current measures cover a single department (too narrow to be relevant to patients) or outcomes for a whole hospital, such as infection rates (too broad to be relevant to patients).Outcomes should include the health circumstances most relevant to patients. They should cover both near-term and longer-term health, addressing a period long enough to encompass the ultimate results of care. And outcome measurement should include sufficient measurement of risk factors or initial conditions to allow for risk adjustment.

I believe that below mentioned four areas are important to be added as value-services in Paradise Hospital and for the betterment of its patients too. Each of the area contains one or more distinct outcome dimensions. For each dimension, success is measured with the use of one or more specific metrics.

Area 1 is the health status that is achieved or, for patients with some degenerative conditions, retained. The first level, survival, is of overriding importance to most patients and can be measured over various periods appropriate to the medical condition; for cancer, 1-year and 5-year survival are common metrics. Maximizing the duration of survival may not be the most important outcome, however, especially for older patients who may weight other outcomes more heavily.

Area 2 is the degree of health or recovery achieved or retained at the peak or steady state, which normally includes dimensions such as freedom from disease and relevant aspects of functional status.

Area 3 is related to the recovery process. The first level is the time required to achieve recovery and return to normal or best attainable function, which can be divided into the time needed to complete various phases of care. Cycle time is a critical outcome for patients — not a secondary process measure, as some believes. Delays in diagnosis or formulation of treatment plans can cause unnecessary anxiety. Reducing the cycle time (e.g., time to reperfusion after myocardial infarction) can improve functionality and reduce complications. The second level in Tier 2 is the disutility of the care or treatment process in terms of discomfort, retreatment, short-term complications, and errors and their consequences.

Area 4 is the sustainability of health. The first level is recurrences of the original disease or longer-term complications. The second level captures new health problems created as a consequence of treatment. When recurrences or new illnesses occur, all outcomes must be re-measured.

Each medical condition (or population of primary care patients) will have its own outcome measures. Measurement efforts should begin with at least one outcome dimension at each tier, and ideally one at each level. As experience and available data infrastructure grow, the number of dimensions (and measures) can be expanded.

Improving one outcome dimension can benefit others. For example, more timely treatment can improve recovery. However, measurement can also make explicit the tradeoffs among outcome dimensions. For example, achieving more complete recovery may require more arduous treatment or confer a higher risk of complications. Mapping these tradeoffs, and seeking ways to reduce them, is an essential part of the care-innovation process.

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