What Do Doctors Think About Value-Based Healthcare? A Survey of Practicing Physicians in a Private Healthcare Provider in Brazil (Editor's Choice)



As health systems start to discuss alternative payment models for fostering value in healthcare, there is increased interest in understanding how physicians will cope with different remuneration schemes. We conducted a survey of physicians practicing at Hospital Israelita Albert Einstein, a nonprofit private healthcare provider in Brazil, aimed at capturing their awareness of value-based healthcare (VBHC).


Our study uses data from a survey administered to doctors practicing at Einstein between September and November 2018. Descriptive statistics and adjusted multivariate logistic regression analyses were used to describe physicians’ characteristics associated with their views on VBHC.


A total of 1000 physicians completed the survey (response rate: 13%). Although only 25% knew the value equation, 67% defined value in health according to Porter’s—the outcomes that matter to patients in relation to the costs of offering such outcomes. Most participants identified increased healthcare costs as the main reason for the discussions over new financing models. Only 27% of physicians rated their awareness of VBHC as high or very high. In the multivariate analysis, awareness of VBHC was associated with holding a management position, scoring high in the hospital’s physician segmentation program, being familiar with the value equation, and attributing high importance to developing new VBHC financing models for health system transformation.


Physician awareness of key VBHC concepts is still heterogeneous in our clinical setting. Promoting opportunities for involving physicians in the discussion of VBHC is key for a successful value-driven transformation of healthcare.


Marcia Makdisse Pedro Ramos Daniel Malheiro Marcelo Felix Adriana Cypriano Juliana Soares Andrea Carneiro Miguel Cendoroglo Neto Sidney Klajner

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