Joint Value: The Impact of Implementing Patient-Centered Value-Based Healthcare Over the Patient Journey of Inflammatory Arthritis

OBJECTIVES: Patient-centered value-based healthcare (PCVBHC) is widely believed to help care organizations deliver the best patient-relevant outcomes relative to their costs. However, evidence on the impact of transforming care organizations into a well-functioning integrated practice network is missing. So far, care organizations have not implemented all reinforcing VBHC steps, and often patient-centered care (PCC) has not been put at the heart of VBHC. We provide a practical PCVBHC roadmap, with evidence on its impact on the individual patient (micro), department (meso) and regional and national providers (macro) level.

METHODS: The rheumatology department at the Maasstad Hospital, The Netherlands, was selected in 2014 to gradually transform into an integrated practice network called “Joint Value”. Regarding the roadmap, we provide practical examples on how to fulfill all reinforcing VBHC steps based on Porter & Lee and the Value Agenda for the Netherlands, and we display urgent-care cycle improvements that were identified by a patient-partner panel from 2014 onwards.

RESULTS: We highlight evidence on the greatest impact achieved. On the micro level, we display the evaluation of a dashboard based on individual patients’ real-time outcomes, to support shared decision-making, telemonitoring and coaching. On the meso level, we report our efforts to start steering on patient-relevant outcomes relative to their costs using management dashboarding. On the macro level, we display the impact of collaborating in external benchmarking with the Santeon hospital group. We are the first to collect and compare real-world data on clinical and patient-reported outcomes to learn from each other.

CONCLUSIONS: We have established a PCVBHC roadmap that may be used by other indications, with the potential to serve as an evidence-based PCVBHC blueprint. We continue our efforts by examining how the value equation (patient-relevant outcomes relative to their costs) should be operationalized and measured.