What is value in healthcare? It’s not just about costs, though that’s a big part of it.
What does value really mean for people who need health services? For the healthcare professionals and systems that deliver that care?
Value also factors in the “worth” of the services provided – after considering costs, patient preferences, and alternatives, which health services provide the greatest possible health benefit at the lowest possible cost? What services may offer little to no benefit, or may even be harmful if they turn out not to be necessary?
Making those decisions about the value of care, both on the “consumer” side and at the healthcare systems level, requires evidence – and developing that evidence through rigorous evaluation is a major IHPI research priority.
Spending less for the care needed most
Millions of Americans with common chronic conditions could see reduced out-of-pocket costs for essential medications and health services as the result of a new federal rule issued in July 2019. The rule, which applies to certain types of high-deductible health plans, came about in part through more than a decade of work by the U-M Center for Value-Based Insurance Design and others, who have found that financial barriers – such as high deductibles – can prevent those with chronic conditions from seeking necessary care, and that value-based insurance design plan structures can help people access high-value clinical services and lead to improved health and reduced healthcare spending.
What works, when, and for whom?
Are patients receiving appropriate advanced imaging – such as CT, MRI, and PET scans – throughout Michigan Medicine, and can the use of this imaging be improved? How can health systems reduce unnecessary screening for Vitamin D deficiency? How can patients with chest pain be treated more effectively in the emergency department? These are just some of the major evaluations of the Michigan Program on Value Enhancement (MPrOVE), which works to identify, design, and rigorously and rapidly assess projects focused on improving quality and demonstrating the value of clinical services at U-M and beyond.
Efforts from MPrOVE’s Research Innovation Challenge in 2017 launched a research incubator dedicated to assessing the value of telehealth services, a National Poll on Healthy Aging module that gauged older adults’ readiness for virtual visits, and a national study on how medical specialty care is being delivered across the U.S. Future research endeavors plan to assess the landscape of telehealth across different health systems and payers.
Where connections spark value innovation
New in 2019: the launch of MPrOVE’s Innovation to Implementation (i2i) Lab, geared to accelerate ideas for improving value through evaluation or intervention projects within health systems, including Michigan Medicine and beyond. Dozens gathered for the i2i Kickoff in October and developed plans to present proposals and critique ongoing work at monthly lab sessions.