Value Management in Healthcare: How to Establish a Value Management Office to Support Value-Based Outcomes in Healthcare, Second Edition
Nathan William Tierney
Contents
Preface…………………………………………………..ix
Introduction……………………………………….xi
Acknowledgments…………………………………………………………………………xv
1 Executive Summary…………………………………………………………….1
2 Healthcare Landscape………………………………………………………….9
3 How to Measure Value……………………………………………………….18
4 Value Management Office…………………………………………………..37
5 Value Realization Framework……………………………………………..47
6 Steps in the Value Realization Framework……………………………71
7 Outcome Metrics……………………………………………………………..118
8 Common Operating Picture………………………………………………167
9 Program Core Metrics………………………………………………………189
10 Technical Metrics…………………………………………………………….198
11 Other Index Metrics………………………………………………………..213
12 Change Management………………………………………………………..217
13 Summary of Key Points……………………………………………………238
14 Has Value-Based Care Failed?……………………………………………240
15 The Transformative Role of Artificial Intelligence (AI) in Advancing Value-Based Healthcare…………………264
16 A Father’s Perspective of Type 1 Diabetes and Its Impact on His Child……………………………………………..279
17 Reflections……………………………………………………………………..305
Index…………………………………………………………………………………..311
Preface
As a means of communication, stories convey understanding. Storytelling is the most powerful communication tool we have, and through these stories, we can lead and define future moments. Within the healthcare community, a place is needed where organizations can share their own value stories.
There are four factors that determine why storytelling is so powerful, and why it is possible to make implementing a value management office a successful story:
History: Since the beginning of our existence, humans have shared stories of their experiences, whether through cave paintings, drama, or literature. Alexander Fleming’s 1928 discovery of penicillin led to the treatment of infections, which has had a distinct impact on health outcomes.
Cultures: At their root, cultures are just a collected group of stories and experiences. We as Americans are completely different from the Spanish in how we became a nation, our view of the world, our language, and in many other ways by how we have grouped our own unique stories. As an example, while others have embraced universal healthcare, we in the United States have not, but we conduct more than double the number of MRI and CT tests compared to other OECD countries.
Remembrance: Stories have helped us remember and correlate items of similar and differing interest in a way that is expandable in our own personal learning experience (2 + 2 = 4 and later we learn 4 × 6 = 24). An invasive surgery can have a lasting impact on a health outcome, but at its procedural root, education and remembrance shape the quality of the surgery and its outcome.
Identity: Identity is shaped by the unique stories people tell and those other people share. For most of us, these stories are the ones we want to share and are comfortable sharing, not those about the unpleasant things in life. As a healthcare provider, what is your selfless identity shaped by?
Struck by my own experiences at Walter Reed Medical Hospital, stories from our returning warriors, and work at the Department of Veterans Affairs, I have wondered, “How do we harness the power of storytelling and place it into a narrative that resonates with people?” The resounding answer is full transparency and telling our story of how we are incrementally improving the delivery of healthcare value outcomes. As Dr. Pamela Rutledge, author of The Psychological Power of Storytelling, said, “When organizations, causes, brands or individuals identify and develop a core story, they create and display authentic meaning and purpose that others can believe, participate with, and share. This is the basis for cultural and social change.”