We go to hospitals and receive treatment for different diseases. But are we only given medication, or are we receiving value-based care? Healthcare institutions have answered this positively over the past many years, yet much remains to be done. To gain deeper insights into the concept of value in healthcare, we had an exclusive conversation with Reem F. Bunyan, Executive Director at the Global Innovation Hub for Improving Value in Health. This is a must-read article for anyone seeking a clearer understanding of this vital approach.

MedEdge MEA: How do you define ‘value’ in healthcare?

Reem F. Bunyan: Delivering better value is the “north star” to steer healthcare policy and practice in the right direction. When decisions are made, at any level by policymakers or frontliners, the impact of these decisions on value needs to be considered. What are the resulting outcomes delivered for patients, and what other benefits are delivered to communities and the population? And what resources will be expended to deliver these benefits? Put simply, value describes the relationship between outcomes that matter most for patients and the resources used to generate these.

“Value” might seem a rather abstract concept. It may be easier to recognize, in more practical terms, what is “good value”. Clearly, a healthcare system that delivers timely, respectful and effective care to patients, demonstrates high efficiency, encourages a healthy population and makes a strong contribution to the national economy is good value.

Globally, many national health systems are moving towards value-based healthcare, emphasizing better value as a core goal. The difficulties common to all health systems – increasing demand from aging populations with increasingly complex health needs, the imperative for sustainability in funding, ensuring quality, access and equity, mean health systems must change.

ME: What are the biggest successes and ongoing hurdles in implementing value-based care globally?

RFB: The conundrums that face health systems are substantial and persistent, so it is not surprising that few examples of truly high-value health systems are evident. However, strong progress has been made in some health systems. There is increasing consensus among policymakers that we must transform clinical services and incentivize providers based on the value they create rather than the volume of services delivered. The tools and approaches to deliver value-based healthcare are also now well-defined. And there is an encouraging expansion of the evidence base of successful transformation case studies.

What is now needed is both technical and organizational in nature. Implementation of data and systems will be a critical step. But we will also need to ensure that alignment and commitment across the health system matches the scale of the challenge to be faced. We will only realize the full benefits of high-value health systems if we successfully put long-term population needs ahead of shorter-term goals.

ME: What role does innovation, especially digital health and data analytics, play in improving value in healthcare?

RFB: Recent innovations in digital technology, data analysis and artificial intelligence promise much to transform the value delivered in health systems. New medical technologies for diagnostics and treatment may radically improve the quality and efficiency of the services we deliver. And faster, more powerful and granular healthcare data create the scope for innovations in population health management, predictive analytics, drug development, longevity and precision medicine. More prosaically, stronger systems for workforce scheduling, supply chain analytics and optimizing facilities management are delivering efficiency improvements today that make material contributions to health system value. It is important for policymakers to be prudent and realistic when investing in innovation, addressing relevant concerns about equity of access, privacy and security.

ME: How do global collaborations help accelerate innovation in value-based healthcare?

RFB: We know that health policy is highly context-dependent and that each health system will have its own structure, culture, finances and starting points to which health policy will need to be tailored. In fact, we should expect each country to have its own definition of value, reflecting what is important to the population of that nation.

Yet there remains significant scope for countries to learn from one another about how to deliver better health system value. The Global Innovation Hub for Improving Value in Health is an international initiative arising from Saudi Arabia’s presidency of the G20 in 2020 with the role of sharing best practice policies and experiences on high-value care between countries. It is our experience that such global collaborations work best when they are true partnerships, tailored to the specific national context and committed to two-way engagement with local experts and stakeholders.

ME: What emerging trends like climate change or post-pandemic recovery will shape value in health, and advice for emerging leaders?

RFB: High-value health systems are ones that deliver good value to patients and populations over the long run. So, it is critical that we consider resilience and sustainability as part of national healthcare policymaking. For instance, policymakers will need to forestall the impacts of climate change on healthcare demand and supply: varying population and disease patterns, as well as economic and social impacts. The COVID-19 pandemic proved a humbling test for some health systems and, although many lessons have been learned, we can be sure only that the next pandemic will differ from the last in unexpected ways. High-value health systems will be ones that respond to such crises with timely, evidence-based public communications and courageous policymaking in the face of an evolving understanding of the facts.