Value-Based Healthcare: A Primer for the Dermatologist

Dermatology, vol. 240, pp. 1–9

Abstract

BACKGROUND: Value-based healthcare (VBHC) is an increasingly employed strategy to transform healthcare organizations into economically sustainable systems that deliver high-value care. In dermatology, the need for VBHC is evident as chronic skin diseases require long-term, often expensive treatments. This narrative review aims to introduce dermatologists to the principles and implementation of VBHC. SUMMARY: VBHC emphasizes maximizing outcomes that are directly relevant to patients. Key components of VBHC include a systematic assessment of standardized patient-relevant outcomes by using core outcome sets and measurement of healthcare cost for the individual patient. Systematic reporting and comparing of risk-adjusted outcomes across the full cycle of care for a specific condition provide benchmarked feedback and actionable insights to promote high-value care and reduce low-value care. VBHC aims to organize care around the patient in condition-specific and team-based integrated practice units with multidisciplinary collaboration, utilize information technology platforms to enable digital data monitoring, reduce cost, and eventually reform payment systems to support bundled payments for the overall care cycle. VBHC implementation in practice necessitates the establishment of a systematic framework for outcome-based quality improvement, the incorporation of value and outcomes in shared decision-making practices, and the cultivation of a value-centric culture among healthcare professionals through continuous training. KEY MESSAGES: Dermatologists can benefit from implementing VBHC principles in their practice. An essential step toward value-driven dermatological care is to start measuring outcomes relevant for patients for each patient, which is lacking partly due to the absence of core outcome sets developed for clinical practice. By reducing low-value care and emphasizing optimal patient-centered outcomes, VBHC has the potential to improve the quality of care and ensure cost containment. Efforts are needed to enhance the development and uptake of VBHC in dermatological clinical practice to realize these benefits.

Authors 7

1. Deepak M.W. Balak Aachen Department of Dermatology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands, balak.dmw@gmail.com

   Basel

   Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands;

2. Elfie Deprez

   Ghent University Hospital · Ghent University

   Affiliation as printed

   Department of Dermatology, Ghent University Hospital, Ghent, Belgium

   Department of Head & Skin, Ghent University, Ghent, Belgium

   Department of Dermatology, Ghent University Hospital, Ghent, Belgium;

   Department of Head & Skin, Ghent University, Ghent, Belgium;

3. Niels Timo Hilhorst

   Ghent University Hospital · Ghent University

   Affiliation as printed

   Department of Dermatology, Ghent University Hospital, Ghent, Belgium

   Department of Head & Skin, Ghent University, Ghent, Belgium

   Department of Dermatology, Ghent University Hospital, Ghent, Belgium;

   Department of Head & Skin, Ghent University, Ghent, Belgium;

4. Isabelle Hoorens

   Ghent University Hospital · Ghent University

   Affiliation as printed

   Department of Dermatology, Ghent University Hospital, Ghent, Belgium

   Department of Head & Skin, Ghent University, Ghent, Belgium

   Department of Dermatology, Ghent University Hospital, Ghent, Belgium;

   Department of Head & Skin, Ghent University, Ghent, Belgium;

5. Jan Gutermuth

   Vrije Universiteit Brussel · Universitair Ziekenhuis Brussel

   Affiliation as printed

   Department of Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium

   Department of Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium;

6. Willem Jan W. Bos Aachen Department of Internal Medicine

   Leiden University Medical Center

   Affiliation as printed

   Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands

   Department of Internal Medicine, St Antonius Hospital, Utrecht, The Netherlands

   Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands;

7. Jo Lambert corresponding

   Ghent University Hospital · Ghent University

   Affiliation as printed

   Department of Dermatology, Ghent University Hospital, Ghent, Belgium

   Department of Head & Skin, Ghent University, Ghent, Belgium

   Department of Dermatology, Ghent University Hospital, Ghent, Belgium;

   Department of Head & Skin, Ghent University, Ghent, Belgium;