Plain Language Summary

What is it about?

Healthcare systems worldwide face rising costs, aging populations, and increasing chronic diseases while struggling to improve outcomes and reduce inequalities. This is important because traditional healthcare that rewards volume of services rather than patient outcomes has proven inefficient and unsustainable. The researchers addressed the problem that value-based healthcare, which aims to improve patient outcomes relative to costs, has evolved separately from health economics and outcomes research methods, leading to inconsistent implementation. This separation creates a gap where value-based healthcare lacks methodological rigor while proven research methods remain underutilized. The paper proposes integrating these disciplines to create a robust framework for measuring healthcare value. This study demonstrates how health economics methods can provide the analytical foundation needed to successfully implement value-based healthcare programs.

How was the research conducted?

The researchers gathered diverse perspectives to build consensus recommendations for integrating two separate fields. They combined 3 information sources: published literature, expert knowledge, and structured feedback. The team reviewed 109 published articles, interviewed 24 international experts from academia, clinical practice, and policy across 10 countries, and surveyed a 9-member Expert Advisory Board. The study used mixed methods including literature review, semistructured interviews, and structured surveys. The researchers studied published articles and gathered perspectives from experts actively implementing value-based healthcare and conducting health economics research. This method was chosen because understanding the intersection of 2 complex fields required both documented evidence and practical insights from practitioners.

What were the results?

Two-thirds of value-based healthcare studies used some health economics methods, primarily cost analyses, but comprehensive economic evaluations were rare. Experts emphasized that health economics strengths in designing payment incentives, measuring costs, and evaluating outcomes could advance value-based healthcare, while value-based healthcare's patient focus could make health economics more relevant. The surprising finding was extensive variability in how outcomes, costs, and value are measured across initiatives, despite shared goals. The team developed an "IMPACT" framework and recommendations to guide organizations in integrating rigorous methods into value-based healthcare.

Why are the results important?

These results provide healthcare organizations with a roadmap for implementing value-based programs using proven methods, reducing trial-and-error approaches. Findings could enable providers and policy makers to measure outcomes consistently, design better payment models rewarding high-value care, and make evidence-based decisions about healthcare improvements. Patients, providers, hospitals, insurers, and policy makers benefit through better health outcomes while controlling costs, making healthcare sustainable and equitable. Long-term impacts include transforming healthcare systems toward transparent, patient-centered delivery that measures what matters to patients while ensuring financial sustainability.

What are the strengths and weaknesses of this study?

The main strength is the comprehensive approach combining published evidence with diverse international expert perspectives and consensus-building, ensuring recommendations reflect both academic rigor and real-world experience. The limitation is that the literature review was targeted rather than systematic, and experts were purposively selected, meaning recommendations represent expert judgment rather than exhaustive evidence. Future research could systematically evaluate organizations implementing these recommendations to measure whether integrating health economics methods into value-based healthcare improves patient outcomes, reduces costs, and enhances healthcare system performance. 

^{Note: This content was created with assistance from artificial intelligence (AI) and has been reviewed and edited by ISPOR staff. For more information or for inquiries on ISPOR’s AI policy, click here or contact us at info@ispor.org.}