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How can healthcare managers measure value based performance?

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Value-based performance (VBP) is a strategy to improve the quality and efficiency of healthcare services by aligning incentives and outcomes. Healthcare managers play a key role in measuring and managing VBP, as they are responsible for designing, implementing, and evaluating the processes and systems that support it. In this article, we will discuss some of the methods and tools that healthcare managers can use to measure VBP, and how they can use the results to improve their performance and achieve their goals.

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1 Define value and performance

The first step to measure VBP is to define what value and performance mean for your organization, your stakeholders, and your patients. Value can be defined as the ratio of outcomes to costs, or the benefit that a service or intervention provides relative to its resource consumption. Performance can be defined as the degree to which a service or intervention meets or exceeds the expectations and needs of the stakeholders and the patients. These definitions should be aligned with your mission, vision, and values, and reflect your strategic objectives and priorities.

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Fred Pane

Vice President at Capstone Health Alliance
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In 2004, I published the first article on Risk Based/Value Based Contracting for drugs and then a couple years later. The goal was to tie Clinical outcomes to a drug and if it didn’t deliver, you don’t pay for it. We measured all types of clinical metrics and patient outcomes when I was in hospital practice. Reocclusion rates post PCI, 30 day readmissions, infection rates, etc. you lead or you follow!

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Mini George

Cluster HR Manager | Certified HR Professional
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First of all, understanding the mission, vision, priorities, and objectives of your organization is crucial for aligning efforts toward accomplishing patient satisfaction. When measuring Value-Based Performance (VBP), you're essentially assessing the relationship between the costs and benefits of a service and the performance in delivering that service. Remember, a patient-centered approach and a commitment to continuous improvement are central to achieving success in Value-Based Performance. We must regularly review and adjust our strategies based on feedback, outcomes, and the evolving landscape of healthcare.

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Destiny Abigail
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Implementing machine learning algorithms to dynamically adjust treatment plans based on real-time patient data is a way to advance beyond the bandit example in Value-Based Performance (VBP) measurement. Predictive modeling can identify interventions likely to yield positive outcomes for specific patient populations by considering various factors like demographics, medical history, and environmental influences. Integrating decision support systems with electronic health records can streamline evidence-based care delivery and promote efficiency in healthcare services. #vscleadeeship

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Katherine J Sullivan, PhD

Founder 360 Wellness Solutions, LLC
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If you want to run a hospital, clinic, or nursing home like a hotel, then you are NOT in healthcare. The triple aim of healthcare reform is: 1. Better healthcare by licensed professionals directing care. HEALTHCARE IS NOT: Increased profits by giving unskilled care to sick and elderly patients. 2. Better health of patients and family members who care about them. HEALTHCARE IS NOT: Preventing patients and families from being with family members when a baby is born or a grandparent is dying or taking their SSI to cover your mismanagement 3. At reduced cost to Medicare. Healthcare costs are rising, care is less accessible, and our children are being killed and neglected by healthcare administrators

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2 Choose relevant indicators and metrics

The next step to measure VBP is to choose the indicators and metrics that will help you monitor and evaluate your value and performance. Indicators are qualitative or quantitative measures that reflect a specific aspect or dimension of value or performance, such as patient satisfaction, clinical quality, safety, efficiency, or equity. Metrics are the units or scales that are used to quantify or express the indicators, such as percentages, scores, rates, or ratios. You should choose indicators and metrics that are relevant, reliable, valid, feasible, and actionable, and that cover the different domains and levels of your organization and your services.

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Arpan Parikh, MD, MBA, FAPA

Chief Medical Officer @ SOL Mental Health | Advising start-ups and investors | Wharton MBA
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When choosing the indicators and metrics, it’s critical to remember that incentives matter and drive behavior. In many instances, metrics are chosen without fully considering the potential misalignment of incentives they can create across different layers or verticals of the team. This can lead to the aimless pursuit of achieving a particular metric to the detriment of the overall mission and vision of the organization, which in the case of a healthcare services business, ought to always include the health, wellness, and happiness of the patient.

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Destiny Abigail
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This is spot on, incorporating specific outcome metrics such as patient-reported outcomes (PROs), quality-adjusted life years (QALYs), or other patient-centered measures to assess value. Performance could extend to include not only meeting expectations but also exceeding them by demonstrating innovations in care delivery, patient satisfaction improvements, or population health outcomes. Additionally, leveraging advanced analytics and predictive modeling to anticipate future value and performance trends could be part of the advanced approach. This ensures a more comprehensive understanding and evaluation of VBP within the organization.

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3 Collect and analyze data

The third step to measure VBP is to collect and analyze the data that will inform your indicators and metrics. Data can be collected from various sources, such as electronic health records, patient surveys, administrative databases, clinical registries, or audits. You should ensure that the data are accurate, complete, timely, and consistent, and that they comply with the ethical and legal standards of data protection and privacy. You should also use appropriate methods and tools to analyze the data, such as descriptive statistics, inferential statistics, benchmarking, or dashboards, and to identify the patterns, trends, gaps, and opportunities that will inform your decision making.

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4 Communicate and report results

The fourth step to measure VBP is to communicate and report the results of your data analysis to your stakeholders and your patients. Communication and reporting are essential to ensure transparency, accountability, and engagement, and to foster a culture of continuous learning and improvement. You should use clear, concise, and compelling formats and channels to communicate and report your results, such as graphs, tables, charts, or stories, and to tailor them to the needs and preferences of your audience. You should also highlight the strengths, weaknesses, achievements, and challenges of your value and performance, and provide feedback and recognition to your staff and partners.

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5 Implement and monitor actions

The fifth step to measure VBP is to implement and monitor the actions that will improve your value and performance. Actions are the specific interventions or initiatives that you will undertake to address the issues or opportunities that you have identified from your data analysis, such as process redesign, quality improvement, innovation, or collaboration. You should use a systematic and evidence-based approach to plan, execute, and evaluate your actions, and to involve your stakeholders and your patients in the process. You should also use your indicators and metrics to monitor the progress and impact of your actions, and to adjust them as needed.

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6 Review and revise your VBP measurement system

The sixth step to measure VBP is to review and revise your VBP measurement system periodically, to ensure that it is still relevant, reliable, valid, feasible, and actionable, and that it reflects the changes and developments in your organization, your services, your stakeholders, and your patients. You should use a participatory and reflective approach to review and revise your VBP measurement system, and to incorporate the feedback and lessons learned from your communication, reporting, implementation, and monitoring activities. You should also seek external validation or accreditation of your VBP measurement system, if possible, to enhance its credibility and legitimacy.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Stefani Daniels MSNA, RN, ACM, CMAC

Consultant, educator and professional speaker for hospital case mgmt practice, utilization review, and care coordination across the Continuum. Recent recipient of CMSA's prestigious Lifetime Achievement Award.
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In the field of hospital case management, to determine value, patient care outcomes must be considered. Unless patients/families perceive the interventions and contributions made by the hosptial case manager to have provided value to their progression or care, treatment plan, or transition, the HCM program may have to be re-designed.

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How can healthcare managers measure value based performance?

1

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3

4

5

6

7

1 Define value and performance

2 Choose relevant indicators and metrics

3 Collect and analyze data

4 Communicate and report results

5 Implement and monitor actions

6 Review and revise your VBP measurement system

7 Here’s what else to consider

Healthcare Management

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How can healthcare managers measure value based performance?

1

2

3

4

5

6

7

1 Define value and performance

2 Choose relevant indicators and metrics

3 Collect and analyze data

4 Communicate and report results

5 Implement and monitor actions

6 Review and revise your VBP measurement system

7 Here’s what else to consider

Healthcare Management

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