• Global leaders from the healthcare sector unite to appeal for a new model of healthcare delivery in response to rising costs and dissatisfactory patient outcomes. The value-based healthcare model would track and pay for healing, instead of treating, patients
• Signatories include the Chief Executives/Presidents of Kaiser Permanente, Medtronic, Novartis, Qualcomm Life and Takeda Pharmaceutical Company, the Minister of Health of the Netherlands, the Chief Executive Officer of the National Health Service England and Harvard’s Michael Porter
• The model will be implemented in four pilot markets in 2017, beginning in Atlanta, USA, where the start was announced on 25 April, and later in the Netherlands, Singapore and the People’s Republic of China.
• Download the full report here

New York, 26 April 2017 — A diverse group of leading stakeholders in the $7.6 trillion global healthcare sector are calling for a major overhaul of healthcare systems, designed to deliver improved patient outcomes at lower cost. The proposal hinges on “value-based healthcare”, a patient-centric system that focuses on outcomes that matter to patients across the care spectrum. The recommendations are presented in a new World Economic Forum report, Value in Healthcare: Laying the Foundation for Health-System Transformation, released today in collaboration with Boston Consulting Group, and to be implemented in four pilot locations, starting in Atlanta (USA) this year.

Shifting the focus of healthcare to outcomes would enable health systems to address the rising costs, the signatories say. “Value-based care represents our best chance at ensuring that health systems of the future can deliver those outcomes that matter to patients at sustainable, long-term costs,” said Arnaud Bernaert, Head of Global Health and Healthcare Industries at the World Economic Forum.

Supporters of the appeal for a value-based healthcare approach include Omar Ishrak, Chairman and Chief Executive Officer, Medtronic, Joseph Jimenez, Chief Executive Officer, Novartis, Michael Porter, Bishop William Lawrence University Professor, Harvard Business School, Edith Schippers, Minister of Health, Welfare and Sport of the Netherlands, Simon Stevens, Chief Executive Officer, National Health Service England, Bernard J. Tyson, Chairman and Chief Executive Officer, Kaiser Permanente, Rick Valencia, President, Qualcomm Life, and Christophe Weber, President and Chief Executive Officer, Takeda Pharmaceutical Company. It is the first time that such a diverse group of leaders have aligned on a system-level approach to healthcare reform. (See quotes below.)

The report suggests three foundational principles to provide the basis for value-based care:

• Measuring outcomes and costs, i.e. the systematic measurement of the health outcomes that matter to patients and the costs required to deliver them across the full cycle of care
• Focusing on population segments that are clearly defined, and the health outcomes and costs associated with them; and
• Customizing segment-specific interventions, developed to improve value for each population segment

Four key enablers of value in healthcare support and facilitate the reorientation of health systems around these three principles:

• Informatics – including shared standards and new capabilities that enable the routine collection, sharing and analysis of outcome data and other relevant information for each population segment
• Benchmarking, research and tools – including systematic benchmarking for continuous improvement; identification of variations in responses to treatment and of emerging clinical best practices; new data sources for research and innovation, and new approaches to clinical trials; and the development of sophisticated decision support tools for clinicians and patients
• Payments – including new forms of compensation and reimbursement that help to improve patient value
• Delivery organization – including new roles and organizational models that allow providers and suppliers to adapt to new opportunities and innovations, provide better access to appropriate care and engage clinicians in continuous improvement

The report emphasizes that national political leaders and policy-makers have a central role to play in accelerating the transition to a value-based health system, a point stressed by several of the signatories.

To put its recommendations in practice, the Value in Healthcare project has begun working with 20 payer, provider, supplier and government organizations in the US state of Georgia on a pilot project to create a comprehensive value-based approach to heart failure in the Atlanta metropolitan area. “As the Mayor of the City of Atlanta, I am excited to host the first pilot program to focus on value-based healthcare with the World Economic Forum and our private sector partners,” said Mayor Kasim Reed of Atlanta.

“Over the next several months, the Atlanta working group will design a roadmap for implementing value-based health care for patients with heart failure, and will then put our work to the test, and see real-world examples of how value-based health care can affect outcomes. We have a bold vision: to become a national leader in heart-failure survival in the United States while improving the quality of life and reducing the cost of care for our residents. This pilot program lays the groundwork for us to achieve this audacious, but attainable goal.”

In addition to the Atlanta project, three more regional pilots will be conducted this year in the Netherlands, Singapore and the People’s Republic of China. The report and call to action were prepared by the World Economic Forum in collaboration with The Boston Consulting Group (BCG).

Global Health Industry Leader Views

“Current traditional care models incentivize volume. At the heart of value-based healthcare is a shift to put the patient back at the center of care – what’s best for the patient should drive the system, rather than the volume of procedures,” said Omar Ishrak, Chairman and Chief Executive Officer, Medtronic. “By shifting the focus to outcomes, we can improve the health of patients and also contain costs for the system. The medical technology industry plays a leading role in driving value creation. New innovation will be required to ensure continual improvement in outcomes and reduction in cost rather than one-time savings.”

“The beauty of value-based healthcare is that it focuses on doing the right thing for patients, while putting healthcare systems on a sustainable path,” said Joseph Jimenez, Chief Executive Officer, Novartis, and co-chair of the project’s executive board. “By eliminating interventions that don’t deliver positive outcomes and by avoiding complications, healthcare systems can reduce a lot of the waste that today accounts for as much as 30% of total healthcare spend. As an industry, we must seize the opportunity today to support the transition to value-based healthcare, which will have profound benefits for future generations.”

“Getting value-based healthcare right will require political commitment at the highest levels,” added Michael Porter of Harvard Business School.  “International organizations, governments and clinicians must work together to better measure the impact of care on people’s daily lives, and thereby assess the value that health systems create. This, after all, is the ultimate measure of success.”

“We believe that national health systems face an extraordinary opportunity: to deliver substantially improved health outcomes to patients and at significantly lower cost than health systems today are able to achieve,” said Bernard J. Tyson, Chairman and Chief Executive Officer, Kaiser Permanente.  “Working with the Mayor of Atlanta, our goal is to position Atlanta as a national leader in heart failure survival and quality of life.”

“This is a landmark milestone on the path toward value-based healthcare because standardized measurement and data transparency around the world creates an unparalleled opportunity to learn from high-performing clinical teams and innovators, no matter where they operate,” said Rick Valencia, President, Qualcomm Life and co-chair of the project’s executive board.

“Value-based healthcare creates a common frame of reference for the all-important dialogue about price,” said Christophe Weber, President and Chief Executive Officer, Takeda Pharmaceutical Company. “More broadly, it is critical for the alignment of all stakeholders, including pharma and med-tech companies, to take increased accountability for health outcome and its associated cost and contribute more actively to patient value.”

Appendix 1       Implications for the US Health System  

For the US health system, one of the key unanswered questions for the immediate future is the impact of any new administration changes on the value-based initiatives pursued by the Centers for Medicare and Medicaid Services (CMS) in conjunction with the implementation of the Affordable Care Act. The report describes the considerable progress that CMS has made in recent years in the areas of outcomes measurement and value-based payments.  The report indicates that the concept of value-based healthcare is aligned with the stated ambition of the new administration to increase competition in healthcare, especially on the basis of value delivered to patients.

Appendix 2       Growing momentum toward internationally standardized outcome measurement

In January 2017, the Organisation for Economic Co-operation and Development (OECD) and the non-profit International Consortium for Health Outcomes Measurement (ICHOM) agreed to collaborate on creating international standards for outcomes measurement, including patient-reported metrics, and on their use to compare the quality of care across OECD member states.

The World Economic Forum, committed to improving the state of the world, is the International Organization for Public-Private Cooperation. The Forum engages the foremost political, business and other leaders of society to shape global, regional and industry agendas. (www.weforum.org)

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