towards a value-based healthcare system ......towards a value-based healthcare system: from concept...

TOWARDS A VALUE-BASED HEALTHCARE SYSTEM: from concept to implementation

10th April 2019

Dr Cláudia Vaz, Director of Business Development

[email protected]

mailto:[email protected]

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


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


Healthcare spending is growing in an unsustainable fashion

3


Yet there appears to be no correlation between spend and outcomes

2016 data


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


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

1

2

3

4


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


“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?


Agenda

• Why Value Based Healthcare is needed

• Porter’s Model of VBHC

• ICHOM and the adoption of VBHC


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


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


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


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


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.


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


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?


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!


ICHOM 2019 conference

https://www.ichom.org/register-ichom-2019-conference/

https://www.ichom.org/register-ichom-2019-conference/


INTERNATIONAL CONSORTIUM FOR HEALTH OUTCOMES MEASUREMENT

“Using Outcomes Measurement to Transform Healthcare”

towards a value-based healthcare system ......towards a value-based healthcare system: from concept...

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