High-value care aims to achieve the best patient outcomes and satisfaction while minimizing overall costs and unnecessary treatments. It prioritizes patient-centred approaches, efficiency, and long-term sustainability.
However, there are significant challenges in implementing high-value care. These include addressing the generational skills gap among healthcare professionals and encouraging collaboration across various healthcare sectors. Moreover, it is essential to involve patients and citizens in healthcare decision-making to ensure that treatments and innovations meet real needs.
But to get there, we must first change the healthcare paradigm.
Rethinking how we measure health outcomes
Achieving optimal health outcomes remains a significant challenge, largely due to the escalating costs of healthcare and a system that often prioritizes services over patient-centric outcomes.
“The focus in healthcare is to a large extent on services delivered and processes followed, and not on the health outcomes that matter to patients,” says Christina Rångemark Åkerman, member of the Impact Council at Gilde Healthcare.
This misalignment leads to inefficiencies. A report by EIT Health, based on data from the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD), estimates that “around 30% of resources spent on healthcare are wasted on avoidable complications, unnecessary treatments or administrative inefficiencies.”
To truly improve patient health, the focus must shift from the quantity of services provided to the quality and impact of those services on patients’ lives. This requires a comprehensive reevaluation of current healthcare priorities and practices.
Current healthcare payment models are also largely misaligned with the goal of achieving high-value care. As Åkerman points out, “Most payment models focus on the services delivered and not on the health outcomes.” This creates an environment where healthcare providers are incentivized to perform more procedures and tests, rather than focusing on what is truly beneficial for the patient.
By designing payment systems that incentivize high-quality outcomes, healthcare providers can focus on delivering care that genuinely improves patient health. This transition requires redefining the metrics of success in healthcare to prioritize patient recovery and well-being over procedure counts. Such a shift would not only improve patient satisfaction but also contribute to the overall efficiency and sustainability of healthcare systems.
In addition, innovative treatment options such as cell and gene therapies present new challenges in how we measure healthcare outcomes.
“For instance, with haemophilia, if you move from intravenous injections every three to seven days to one gene therapy that will hopefully repair the gene in the body, you need to measure how long this treatment will affect the patient. Will it be lifelong, will it be for a year, two years, ten years? So we need to measure that data and it’s a completely different patient pathway,” explains Thomas Allvin, Executive Director Strategy and Healthcare Systems at the European Federation of Pharmaceutical Industries and Associations (EFPIA). “The key here is to explore new types of partnership models because it needs all stakeholders on board.”
Another pressing issue in high-value care is the allocation of healthcare budgets. Despite the clear benefits of preventive care and health promotion, these areas receive a disproportionately small portion of healthcare funding.
“Resources spent on disease prevention and on health promotion are only around three to four per cent of total health budgets in the OECD countries, while 75 to 80 per cent of the budget are spent on treating chronic conditions,” notes Åkerman.
This imbalance reflects a reactive approach to health care that focuses on treating disease after it occurs rather than preventing it in the first place. Investing more in prevention and health promotion could significantly reduce the incidence of chronic diseases, which currently consume the majority of healthcare resources. By reallocating budgets to prioritize preventive measures, healthcare systems can not only improve population health outcomes but also reduce long-term costs. This proactive approach is essential to achieving sustainable, high-value care, but it’s not the only option.
Four strategies for transformation in healthcare
The transition to high-value care is not just a policy change but a paradigm shift in how we view and deliver healthcare. It requires a comprehensive rethinking of our approach, where the primary goal is the well-being of patients, not just the delivery of services.
Here are four strategies that have been identified by experts:
Reskilling and education
Continuing education and training are critical to adapting to the evolving healthcare landscape. To deliver high-value care, healthcare professionals need to acquire a diverse skill set, particularly in addressing holistic patient needs.
For example, “it is not common for a surgeon to talk about depression with a patient,” says Jan A. Hazelzet, Professor Emeritus in Healthcare Quality & Outcome at Erasmus MC. Yet, when outcomes reveal mental health issues, the care team must ensure these are addressed by qualified professionals. This underlines the importance of interdisciplinary training and teamwork.
Modern healthcare professionals must be “more trained to be a team player than to be an individual who is deciding,” continues Hazelzet, reflecting a shift from individual to collective expertise.
However, Hazelzet notes that medical curricula are updated every seven years, which slows the integration of new topics. He also mentions that the curriculum is often shaped by more experienced professionals who may not fully embrace patient-centred care.
Addressing the generational gap is also a significant challenge when it comes to digital skills among healthcare professionals. Hazelzet acknowledges the potential generational conflict, noting, “If there are older physicians who are not skilled in digital consultation, they should be educated.” Bridging this gap requires comprehensive training programmes that equip older professionals with necessary digital competencies while ensuring that younger, digitally adept practitioners appreciate the value of face-to-face consultations.
Educating healthcare workers to navigate these multifaceted responsibilities is essential for delivering comprehensive, effective, and sustainable patient care.
Public and private sector collaboration
Collaboration between the public and private sectors is fundamental to drive innovation in healthcare and ensure high-value care. Allvin highlights the persistence of silos between healthcare and industry as a challenge to high-value care. For him, “There are many different understandings of value, or what matters to patients.”
This misalignment affects how health systems and payers signal to the pharmaceutical and medtech industries which innovations to invest in. He notes that development processes, especially in pharmaceuticals, require stable, long-term signals from health systems to guide research and investment decisions.
Bridging these silos, he argues, requires a common understanding of value that encompasses what really matters to patients. “The key here is to explore new types of partnership models”, he concludes.
Public-private partnerships, such as the Innovative Health Initiative, co-founded by pharmaceutical companies and the European Commission, are key platforms for fostering such collaboration.
The European University Hospital Alliance, comprising nine hospitals, also demonstrates the importance of collaborative efforts by focusing on outcomes and care paths, initially perceived as the core of high-value care.
By combining resources, expertise, and perspectives from both the public and private sectors, healthcare can advance more rapidly and effectively, ensuring that innovations are patient-centred and sustainable.
Person-centred care
Person-centred care is at the heart of modern healthcare, prioritising the interaction between healthcare professionals and patients. But high-value care goes beyond patient-centred care, and places emphasis on mutual respect for values and needs.
Hazelzet explains, “Despite the fact that we are working on evidence-based medicine, it’s the individual interpretation that is important.”
Personalised care is essential, as standardised treatments do not always align with individual patient needs. For instance, an evidence-based medical recommendation might suggest one direction, but “for this particular patient, it is more wise to decide on direction B,” says Hazelzet. This tailored approach ensures that healthcare is both effective and respectful of individual patient circumstances.
Åkerman points to the Swedish National Cataract Register as a practical example of what this means for high-value care.
The registry is based on a study of nearly 10,000 patients who underwent cataract surgery. The vast majority of these patients had improved vision, but seven per cent of them also reported being worse off in their daily activities than before treatment.
When studying the result in further detail, it was found that these individuals with greater difficulty with daily activities were often older individuals who spent most of their time reading, crafting and doing other activities that depend on strong near distance vision.
“The treatment had restored long-distance vision but many of them had not received reading glasses to support near vision. As a result of that, their quality of life deteriorated following the treatment.”
For her, this example is a strong argument in favour of keeping a more informed discussion with the patient after treatment.
“These types of informed discussions with the patients are key as we are not aiming for more care but for better health.”
Citizen and patient involvement
Involving citizens and patients throughout the healthcare innovation cycle is crucial to addressing unmet needs and improving outcomes. Ania Henley, Public Involvement Advisor at Imperial College NIHR Biomedical Research Centre, argues, “Without citizen and patient involvement, unmet needs will not be defined and therefore outcome that matters won’t be fulfilled.”
According to her, effective patient involvement consists of several stages: identification, ideation, and innovation. During identification, patients help identify social needs and participate in research and scoping exercises. In ideation, they contribute to planning, designing, and evaluating projects, often serving on steering committees. Finally, in the innovation stage, patients assist in implementing, assessing, and disseminating new solutions.
“In the UK, if you get funding from the government, you have to involve patients,” explains Henley. “You cannot get granting unless you show on your grant application how you’re going to involve patients.”
She adds that this principle could be expanded to Europe, as it’s proven to be an effective strategy in the UK. “I think it should become automatic. It has to become the law,” she concludes.
Towards a resilient and sustainable care
The resilience of healthcare systems is a critical component in ensuring that they can withstand and adapt to challenges, such as those presented by the COVID-19 pandemic. Åkerman emphasizes that “being healthy is key not only to the individual but also for the resilience of the health systems.”
She also highlights the ability of healthcare workers to perform their duties without experiencing burnout as a crucial parameter for maintaining the overall effectiveness and efficiency of healthcare delivery. By focusing on resilience, we can create a system that not only responds to crises but also maintains a high standard of care under normal conditions.
This includes ensuring that healthcare environments are supportive and sustainable, which in turn makes healthcare a more attractive and viable career option for professionals. Ultimately, resilient healthcare systems are better able to provide continuous, high-quality care to patients, regardless of external pressures.
High-value care is achievable, but it requires dedication, collaboration, and a relentless focus on quality and patient satisfaction.