TOWARDS A VALUE-BASED HEALTHCARE SYSTEM: from concept to implementation
10th April 2019
Dr Cláudia Vaz, Director of Business Development
1Copyright © 2018 by the International Consortium for Health Outcomes Measurement. All rights reserved.
Agenda
• Why Value Based Healthcare is needed
• Porter’s Model of VBHC
• ICHOM and the adoption of VBHC
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WHY IS VALUE BASED HEALTHCARE IMPORTANT?
There is a global need for VBHC
• Global healthcare spend continues to outpace growth in GDP
• Variable health outcomes are delivered across OECD countries
• Reimbursement remains tied primarily to volume in countries across the world
• This need has been recognised by patients, providers, payers, suppliers and governments alike
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Healthcare spending is growing in an unsustainable fashion
3
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Yet there appears to be no correlation between spend and outcomes
2016 data
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Variation in health outcomes is a worldwide problem
But, for outcomes that matter most to patients – improvement in their symptoms, functioning, and well-being – this only begins to describe the magnitude of the problem.
variation in 30-day mortality rate from heart attack in US hospitals
variation in bypass surgery mortality in the UK hospitals
Variation of major obstetrical complications among US hospitals
variation in complication rates from radical prostatectomies in the Dutch hospitals
variation in reoperation rates after hip surgery in German hospitals
variation in mortality after colon cancer surgery in Swedish hospitals
variation in capsule complications after cataract surgery in Swedish hospitals
4x
9x
18x
20x
36x
2x
5x
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The lack of outcome measurements representing what matters most to patients is a global barrier to healthcare improvement
Paucity of outcomes data beyond basic mortality measures
Where available, outcomes are hard
to compare and not standardized
Outcomes are often not patient- focused
Large focus on process measures
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2
3
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8Copyright © 2018 by the International Consortium for Health Outcomes Measurement. All rights reserved.
ICHOM was formed to catalyze the transformation to VBHC
Our missionICHOM History
Founded in 2012 by thought leaders with the desire to use outcome measurement to unlock the potential of value-based health care.
ICHOM is a nonprofit▪ Independent 501(c)3 organization▪ Idealistic and ambitious goals▪ Global focus▪ Engages diverse stakeholders
Value =
Our mission
Unlock the potential of value-based health care by defining global Standard Sets of outcome measures that matter most to patients across a wide range of
medical conditions, and driving the adoption and reporting of these
measures worldwide
Cost of delivering those outcomes
Patient health outcomes achieved
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“Outcomes are the results people care about most when seeking
treatment, including functional improvement and the ability to live normal, productive lives.” – ICHOM
How do we define a health outcome?
17Copyright © 2018 by the International Consortium for Health Outcomes Measurement. All rights reserved.
Agenda
• Why Value Based Healthcare is needed
• Porter’s Model of VBHC
• ICHOM and the adoption of VBHC
18Copyright © 2018 by the International Consortium for Health Outcomes Measurement. All rights reserved.
ICHOM defines internationally recognized Standard Sets of outcomes and related case-mix factors
ICHOM facilitates adoption and integration of outcomes measurement by sharing knowledge and support
ICHOM will provide risk-adjusted international benchmarks on outcomes by medical condition
ICHOM will enable cooperation and create outcome measurement communities to share best practices
ICHOM is developing a new paradigm focused on health outcomes – the results that matter most to
patients.
HOW DOES ICHOM WORK TOWARDS VBHC?
VALUE-BASED
HEALTHCARE
19Copyright © 2018 by the International Consortium for Health Outcomes Measurement. All rights reserved.
We need standardisation so that we can meaningfully and reliably compare the same outcomes
Comparing apples withoranges is a lot harder than…. …comparing apples with apples
Measuring different outcomes in different ways makes it impossible to meaningfully compare
20Copyright © 2018 by the International Consortium for Health Outcomes Measurement. All rights reserved.
ICHOM organises Working Groups to define Standard Sets of outcomes we recommend all care providers track
Clinical and registry leaders Patient representatives
ICHOM facilitates a process with international clinical and registry leaders and patient representatives to develop a
global Standard Set of outcomes that really matter to patients, along with
corresponding case-mix factors
21Copyright © 2018 by the International Consortium for Health Outcomes Measurement. All rights reserved.
Our Standard Sets have been developed by leading clinical experts originating from 44 countries
Indon.KSA
SwiIre Den Nor SweSpain Italy
NZ
Twn
Japan
Malay
Chile
Peru
Mex
IsraelUga Sing. Aus
US
Fra
Can
Brazil India
S. Kor.
Ger Belg.
China
NL
Moroc S. Afr.
UK
StrokeHip & Knee OsteoarthritisMacular DegenerationBreast cancerInflammatory Arthritis
Lung CancerCleft Lip & PalateAdvanced Prostate CancerPregnancy and ChildbirthCongenital Upper Limb Anomalies
Depression & AnxietyParkinson's DiseaseLow Back PainOveractive bladderOral Health
Localized Prostate CancerCoronary Artery DiseaseCataractsCraniofacial microsomia
DementiaHeart FailureOlder personsColorectal cancer
Mozam
Camer Ghana
Inflammatory Bowel DiseaseHypertensionChronic Kidney Disease
Viet.
Bela.Yemen
Arg.HK
UAE
Ngr.
FI
Pediatric Facial Palsy
22Copyright © 2018 by the International Consortium for Health Outcomes Measurement. All rights reserved.
54
49
40
19
0
10
20
30
40
50
60
2015-2016
Burden of Disease Covered (%)
201720142013
ICHOM Standard Sets now cover the majority of high impact disease areas
27 ICHOM Standard Sets to-date
1. Localized Prostate Cancer *2. Lower Back Pain *
3. Coronary Artery Disease *4. Cataracts *
13. Breast Cancer*14. Dementia
15. Heart Failure16. Pregnancy and Childbirth17. Colorectal Cancer*18. Older Persons19. Overactive Bladder*20. Craniofacial Microsomia21. Inflammatory Bowel
Disease
5. Parkinson’s Disease*6. Cleft Lip and Palate*
7. Stroke *8. Hip and Knee Osteoarthritis*9. Macular Degeneration*10. Lung Cancer*11. Depression and Anxiety*12. Advanced Prostate Cancer *
22. Chronic Kidney Disease
23. Hypertension24. Inflammatory
Arthritis25. Congenital
upper limb anomalies
26. Pediatric facial palsy
27. Diabetes (I &II)
Committed/In process
▪ Oral health
▪ Atrial fibrillation▪ Overall adult health▪ Overall pediatric
health▪ Hand & wrist
conditions▪ Mental health ▪ Preterm and
hospitalized new born
▪ Congenital heart diseases
• 15 Standard Sets published to date in peer-reviewed journals Percentage of global disease burden coverage is based on Global Burden of Disease Study 2016. Global Burden of Disease Study 2016 (GBD 2016) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2016.
23Copyright © 2018 by the International Consortium for Health Outcomes Measurement. All rights reserved.
ICHOM defines internationally recognized Standard Sets of outcomes and related case-mix factors
ICHOM facilitates adoption and integration of outcomes measurement by sharing knowledge and support
ICHOM will provide risk-adjusted international benchmarks on outcomes by medical condition
ICHOM will enable cooperation and create outcome measurement communities to share best practices
ICHOM is developing a new paradigm focused on health outcomes – the results that matter most to
patients.
HOW DOES ICHOM WORK TOWARDS VBHC?
VALUE-BASED
HEALTHCARE
25Copyright © 2018 by the International Consortium for Health Outcomes Measurement. All rights reserved.
ICHOM has achieved recognition, traction and global impact
Growing Footprint
Wide Coverage
International Collaborations
Strong Engagement
30+ Countries
650+Institutions
100+ Collaborative Relationships Formed
Set Implementation
~3x Yearly increase in conference attendance
27
19 peer reviewed publications
13 sets funded/in progress
completed standard outcomes sets
WHAT HAS ICHOM ACHIEVED SO FAR?
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Our Commitment
ICHOM is at the forefront of innovation, engagement and evidence-based change.
We are committed to tackling inefficiencies in care and providing the best possible health outcomes for patients.
By asking patients what matters most to them, we will drive health improvements which can impact all healthcare actors.Please join us our
mission to transform healthcare!
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ICHOM 2019 conference
https://www.ichom.org/register-ichom-2019-conference/
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INTERNATIONAL CONSORTIUM FOR HEALTH OUTCOMES MEASUREMENT
“Using Outcomes Measurement to Transform Healthcare”