Impact of Cost-Optimization Strategies on Operational Efficiency Service Quality and Financial Sustainability in Colombian Healthcare Providers: A Value-Based Healthcare Approach
Author(s)
JUAN C. FERNANDEZ MERCADO, MBA, MSc, PhD, MD1, Nelson Alvis-Guzman, MPH, PhD, MD2.
1UNIVERSIDAD DE CARTAGENA, Cartagena, Colombia, 2Universidad de Cartagena - ALZAK Foundation, Cartagena, Colombia.
1UNIVERSIDAD DE CARTAGENA, Cartagena, Colombia, 2Universidad de Cartagena - ALZAK Foundation, Cartagena, Colombia.
OBJECTIVES: This study aims to measure the impact of cost optimization strategies implemented by Health Provider Institutions (IPS) on operational efficiency, service quality, and financial sustainability, using performance evaluation models based on the Value-Based Health Care (VBHC) framework and technical efficiency metrics, adjusted to the territorial conditions of high geographic dispersion and morbidity levels in Colombia.
METHODS: A mixed-methods design was applied, integrating quantitative efficiency assessments with qualitative insights from key institutional stakeholders. Data were collected from a sample of 15 IPS located in high-dispersion territories between 2022 and 2024. The Data Envelopment Analysis (DEA) model was used to estimate technical efficiency, while VBHC indicators evaluated outcome-based performance. Thematic content analysis was applied to semi-structured interviews with IPS managers to understand the implementation and barriers of cost optimization initiatives.
RESULTS: The DEA results showed that only 33% of the IPS achieved high technical efficiency, with considerable variability linked to service fragmentation and resource availability. VBHC metrics indicated improvements in patient-centered outcomes, particularly in chronic disease management programs. Cost optimization strategies, especially the adoption of Activity-Based Costing (ABC) and integrated care pathways, resulted in a 12-18% reduction in administrative and clinical costs. However, qualitative findings revealed limitations in interoperability, weak alignment of incentives, and insufficient training in cost management.
CONCLUSIONS: Cost optimization strategies have a measurable impact on improving operational efficiency and service quality, especially when aligned with value-based performance frameworks. Nevertheless, achieving financial sustainability remains constrained by structural barriers such as underfunding, technological gaps, and regulatory complexity in dispersed territories. The study recommends the institutionalization of performance-based contracting models and the integration of cost-efficiency tools in IPS strategic planning, tailored to regional epidemiological and territorial conditions.
METHODS: A mixed-methods design was applied, integrating quantitative efficiency assessments with qualitative insights from key institutional stakeholders. Data were collected from a sample of 15 IPS located in high-dispersion territories between 2022 and 2024. The Data Envelopment Analysis (DEA) model was used to estimate technical efficiency, while VBHC indicators evaluated outcome-based performance. Thematic content analysis was applied to semi-structured interviews with IPS managers to understand the implementation and barriers of cost optimization initiatives.
RESULTS: The DEA results showed that only 33% of the IPS achieved high technical efficiency, with considerable variability linked to service fragmentation and resource availability. VBHC metrics indicated improvements in patient-centered outcomes, particularly in chronic disease management programs. Cost optimization strategies, especially the adoption of Activity-Based Costing (ABC) and integrated care pathways, resulted in a 12-18% reduction in administrative and clinical costs. However, qualitative findings revealed limitations in interoperability, weak alignment of incentives, and insufficient training in cost management.
CONCLUSIONS: Cost optimization strategies have a measurable impact on improving operational efficiency and service quality, especially when aligned with value-based performance frameworks. Nevertheless, achieving financial sustainability remains constrained by structural barriers such as underfunding, technological gaps, and regulatory complexity in dispersed territories. The study recommends the institutionalization of performance-based contracting models and the integration of cost-efficiency tools in IPS strategic planning, tailored to regional epidemiological and territorial conditions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
OP11
Topic
Economic Evaluation, Health Policy & Regulatory, Organizational Practices
Topic Subcategory
Academic & Educational
Disease
No Additional Disease & Conditions/Specialized Treatment Areas