Embracing value-based partnerships: A path to enhanced healthcare outcomes
By Rianne Ernst, MSc, Carlijn de Sonnaville, MSc, Silvia Rohr, PhD, Mark Tolboom, MSc
Understand when value-based partnerships in healthcare create the most impact for patients, and learn how to forge those alliances.
The power of collaboration in the healthcare industry
The healthcare landscape today is confronted with a multitude of challenges that require rethinking of how we organize and deliver care. From rising costs to fragmented services, globally the current healthcare system often struggles to meet the needs of patients, healthcare professionals, and society efficiently. Data from the World Bank, OECD, and WHO show that there is a growing need for financial and human resources, with an estimated shortage of 10 million healthcare workers worldwide by 2030. In addition, people are living longer but also spending more of their lives in illness, leading to an increasing burden of disease. A third key challenge for the future of healthcare is the growing inequity in outcomes and access to care. Addressing these challenges requires a shift toward working together to leverage the strengths of various stakeholders. This is where value-based partnerships (VBPs) come into play.
A VBP is a transformative approach where multiple healthcare stakeholders collaborate with the shared goal of delivering the highest value to patients, the healthcare system, and society. Unlike traditional models that often focus on isolated efforts and competitive dynamics, VBPs emphasize the power of working together to solve common challenges and seize opportunities.
Understanding value-based healthcare
The concept of VBPs is deeply rooted in the principles of value-based healthcare (VBHC). VBHC shifts the focus from merely treating illnesses to optimizing the overall value delivered through healthcare services. According to Michael Porter, one of the founders of VBHC, value in healthcare is defined as:
This definition underscores the importance of achieving meaningful health outcomes for patients while managing costs effectively. In essence, VBHC aims to enhance the quality of care and patient satisfaction while ensuring sustainability and cost efficiency in healthcare delivery.
This definition underscores the importance of achieving meaningful health outcomes for patients while managing costs effectively. In essence, VBHC aims to enhance the quality of care and patient satisfaction while ensuring sustainability and cost efficiency in healthcare delivery.
Why create VBPs?
The motivation for creating VBPs originates from the understanding that many healthcare challenges are complex and multifaceted, requiring collaborative solutions. By joining forces, stakeholders can pool their expertise, resources, and capabilities to address issues that are too daunting to tackle alone. Through new partnerships, we can achieve a synergistic effect where 1+1=3, recognizing that we need each other to find the best solutions.
Healthcare systems around the world face similar challenges, such as aging populations, a rise in chronic diseases, and escalating healthcare costs. VBPs provide a framework for various stakeholders (as shown in Figure 1), including pharmaceutical companies, healthcare providers, payers, and policymakers, to work together to solve these complex issues. By collaborating rather than competing, stakeholders can innovate more effectively, avoid redundant efforts, and create more sustainable solutions. Besides the value for the wider healthcare ecosystem, VBPs provide value for the individual stakeholders as well:
- For patients, the value of VBPs includes improved health outcomes due to optimized treatment and care pathways for their disease and increased empowerment to share their voice as active members in shaping the healthcare environment.
- For pharma companies, the value lies in the opportunity to optimally reach the relevant patient population due to better control of treatment guidelines and to provide insights into the use and efficiency of treatments through real-world data generation.
- For physicians, the value is in being able to provide the best care to their patients and staying up to date on relevant advances in science.
- For providers, VBPs can lead to optimal patient pathways and care delivery resulting in the highest efficiency in care and business processes.
- For payers, VBPs provide the opportunity to explore new models and measures to assess the economic value of treatments due to real-world evidence generation and to ensure adherence to agreements regarding the prescription and use of treatments.
- For policymakers, there is the opportunity to have more control over the sustainability of healthcare systems due to transparency and timely observation of impactful changes as well as proof of commitment from other partners to transform the healthcare system.
Trusted independent third parties are key to facilitating the VBPs as they can moderate discussions, provide an outside-in perspective, and ensure all stakeholders in the partnership can contribute equally.
When to create VBPs
VBPs are particularly beneficial when facing challenges that are difficult but solvable through collective effort and creative thinking. Examples of challenges that could be addressed by leveraging VBPs include inadequate organization of care, limited insight into healthcare data, and targeting a too-broad patient population, amongst others. When tackling such multifaceted challenges, the combined knowledge, skills, and perspectives of diverse partners are crucial for developing effective solutions. VBPs are most effective when all partners contribute essential resources such as time, money, and data. Each stakeholder brings unique strengths to the table, and their combined contributions create a powerful synergy that drives progress. Figure 2 highlights the capabilities pharma can bring including scientific understanding, knowledge of the organization of care, and experience in data management and resources (both time and money). Capabilities brought by other stakeholders include:
- Knowledge of the current treatment guidelines by physicians
- Insight on disease burden and impact on daily life by patients
- Information on potential new models to assess the effectiveness and economic value of treatments by payers
- Roadmap for transformation of care by policymakers
Furthermore, VBPs are successful when collaboration helps to achieve a joint purpose while also allowing each party to reach its independent goals. The common goal for a VBP could be to improve patient outcomes. Independent goals within this could include: to define the best care for patients; to provide the optimal treatment to physicians; to reach the entire target population and maximize return on investment for pharma companies; and to define the exact target population to optimally leverage the healthcare budget for payers. This dual focus on collective and individual objectives ensures that all partners remain motivated and committed to the partnership.
How to create VBPs
Creating successful VBPs requires careful planning and commitment to shared values and goals. Key factors that contribute to effective VBPs include shared ambition, equal investment, willingness to take risks, common language, and facilitation by a trusted third party.
A shared ambition among stakeholders is the cornerstone of a successful collaboration. All partners must align their goals to focus on delivering patient value as defined in VBHC, improving health outcomes while generating cost offsets. This alignment ensures that all parties are working toward a common objective, fostering a unified approach to resolve healthcare challenges.
For a partnership to be successful, all stakeholders must invest equally. This investment includes time, money, or data. When each party contributes resources equitably, it ensures a balanced commitment to the partnership’s success and reinforces the mutual responsibility for achieving the shared goals.
VBPs often involve innovative approaches that carry inherent risks. Stakeholders must be prepared to embrace these risks for the greater benefit of the partnership and the patients they serve. This willingness to venture into new and potentially uncertain areas is essential for driving innovation and achieving significant improvements in healthcare outcomes.
Effective communication is critical for the success of any collaboration. Stakeholders must develop a common language that facilitates clear and efficient communication. This shared language helps to prevent misunderstandings, align expectations, and ensure that all parties have an equal understanding of the objectives, processes, outcomes, and how the success of the VBP will be measured.
The involvement of a trusted, independent third party is crucial in facilitating the partnership. This facilitator helps to ensure trust and confidence among stakeholders, to guide the collaboration process, and to help resolve any conflicts that may arise. In addition, the neutral facilitator can also provide an unbiased perspective that helps keep the partnership focused on its goals.
Steps to implement VBPs
Establishing VBPs is a strategic process that includes five essential steps:
- Define a shared ambition: Align the ambitions of each partner to create a unified vision. This involves identifying common goals and harmonizing strategies to form a cohesive plan, ensuring all partners are working toward the same objective.
- Build trust and relationships: Trust and strong relationships are essential for successful collaboration. This requires transparency about each partner’s goals and contributions, fostering an environment where stakeholders feel confident and committed to the partnership.
- Establish collaboration rules: Clear rules and guidelines ensure smooth and equal collaboration. Defining roles, responsibilities, and decision-making processes helps prevent conflicts and ensures all partners are on the same page.
- Pilot projects: Pilot projects test the feasibility of achieving the shared ambition on a small scale. At the start of these projects, success should be defined and key metrics chosen to assess the success of the partnerships. These initiatives provide valuable insights and demonstrate the potential benefits of the VBP.
- Evaluate and scale: Evaluate the results of pilot projects to determine the potential for scaling the partnership. Using data-driven metrics, partners can assess success, identify lessons learned, refine the approach, and develop strategies for broader implementation.
Examples of successful VBPs
In the past, we have worked on several projects that clearly highlight the potential of VBPs to drive meaningful improvements in healthcare. Below is a description of two of those projects.
Example 1:
A VBP aimed at improving cardiovascular risk management care, focusing on optimizing treatment outcomes and patient care pathways
Cardiovascular (CV) diseases are among the deadliest diseases worldwide and cause significant societal problems. To prevent CV events and reduce their burden on patients, the healthcare system, and society, it is crucial to improve care organization and increase efficiency of care delivery. Prevention is an important way to achieve health gains in CV diseases. To improve secondary prevention care for patients with CV diseases, a global pharma company and five hospitals engaged in a VBP, supported by Vintura, a Cencora company. The pharma company and hospitals shared the same ambition: to improve care for CV patients and reduce the risk of recurrent CV events.
Over the past five years, the collaboration in this VBP led to two overarching outcomes. The first is a blueprint of how to organize secondary prevention in the CV care pathway, including an approach to implement. The second is insight into CV care outcomes leveraging data from electronic patient records (EPDs). Data played a crucial role in this partnership, forming the basis for continuous improvements of CV care. Aggregated data on CV risk factors from the EPDs were gathered and displayed in the CV benchmark. This benchmark provided insights into the impact of CV risk factors on outcomes, enabling evaluation of the care pathway and making the impact of successful interventions visible. The CV benchmark allowed hospitals to gain insights into their own outcomes and compare data between hospitals, facilitating mutual learning to improve nationwide care for CV patients.
To continue improving CV care, it is essential that this initiative will be scaled up nationwide. For this to happen, it is important that more hospitals join this VBP so collaboration between the different lines of care is strengthened. Therefore, the national alliance focusing on improving CV care became a strategic partner to drive rollout further. Through this collective effort, we can ensure better care for CV patients and fewer recurrent events.
Over the past five years, the collaboration in this VBP led to two overarching outcomes. The first is a blueprint of how to organize secondary prevention in the CV care pathway, including an approach to implement. The second is insight into CV care outcomes leveraging data from electronic patient records (EPDs). Data played a crucial role in this partnership, forming the basis for continuous improvements of CV care. Aggregated data on CV risk factors from the EPDs were gathered and displayed in the CV benchmark. This benchmark provided insights into the impact of CV risk factors on outcomes, enabling evaluation of the care pathway and making the impact of successful interventions visible. The CV benchmark allowed hospitals to gain insights into their own outcomes and compare data between hospitals, facilitating mutual learning to improve nationwide care for CV patients.
To continue improving CV care, it is essential that this initiative will be scaled up nationwide. For this to happen, it is important that more hospitals join this VBP so collaboration between the different lines of care is strengthened. Therefore, the national alliance focusing on improving CV care became a strategic partner to drive rollout further. Through this collective effort, we can ensure better care for CV patients and fewer recurrent events.
Example 2:
A partnership designed to enhance multidisciplinary team (MDT) approaches for lung cancer, improving diagnosis, treatment planning, and patient outcomes
Multidisciplinary team meetings (MDTMs) play a pivotal role in the care pathway for cancer patients, serving as critical forums where physicians and healthcare professionals collaboratively integrate diverse aspects of patient care to establish optimal treatment plans. These meetings serve as dynamic platforms, allowing experts from various disciplines to collectively contribute their insights, leading to a holistic understanding of each patient’s case. The collaborative nature of MDTMs fosters informed decision-making, ensuring that treatment strategies align with the latest clinical guidelines. This, in turn, has a profound impact on patient outcomes by enhancing adherence to established protocols and contributing to improved overall survival rates.
There is significant variation in the approach taken by hospitals when conducting MDTMs, including factors such as patient case selection, specialist participation, time allocation per specialist, utilization of technologies, etc. This variability ultimately translates into varying performance levels of MDTMs across hospitals, highlighting the importance for knowledge exchange and cross-hospital learning. To facilitate this process, a global pharma company, together with 10 renowned hospitals and supported by Vintura, a Cencora company, engaged in a VBP with the goal to improve MDTMs for cancer patients. The first project they engaged in was a project to capture those best practices and set up a network to facilitate knowledge sharing.
After the pilot project, this project was scaled up globally, from Denmark to the United States, and from China to Latin America, inspiring many hospitals to further improve their MDTMs. To further scale this initiative, alongside the knowledge exchange networks, a self-assessment model was developed to evaluate different components of an MDT and identify focus areas for improvement.
There is significant variation in the approach taken by hospitals when conducting MDTMs, including factors such as patient case selection, specialist participation, time allocation per specialist, utilization of technologies, etc. This variability ultimately translates into varying performance levels of MDTMs across hospitals, highlighting the importance for knowledge exchange and cross-hospital learning. To facilitate this process, a global pharma company, together with 10 renowned hospitals and supported by Vintura, a Cencora company, engaged in a VBP with the goal to improve MDTMs for cancer patients. The first project they engaged in was a project to capture those best practices and set up a network to facilitate knowledge sharing.
After the pilot project, this project was scaled up globally, from Denmark to the United States, and from China to Latin America, inspiring many hospitals to further improve their MDTMs. To further scale this initiative, alongside the knowledge exchange networks, a self-assessment model was developed to evaluate different components of an MDT and identify focus areas for improvement.
VBPs represent a promising approach to address the complex challenges facing the healthcare system. By fostering collaboration, VBPs can deliver higher value to patients, improve healthcare outcomes, and ensure sustainable and cost-effective care. For more insights and detailed discussions on VBPs, please contact us.
Source
World Economic Forum. Transforming Healthcare: Navigating Digital Health with a Value-Driven Approach. January 9, 2024. Accessed July 15, 2024. https://www.weforum.org/publications/transforming-healthcare-navigating-digital-health-with-a-value-driven-approach/
This article summarises Cencora’s understanding of the topic based on publicly available information at the time of writing (see listed source) and the authors’ expertise in this area. Any recommendations provided in the article may not be applicable to all situations and do not constitute legal advice; readers should not rely on the article in making decisions related to the topics discussed.
Topics:
Consulting
Regulatory
.png?h=320&iar=0&w=540&useCustomFunctions=1¢erCrop=1&hash=591DE13181C8BC503BD937C9303B9EBF)