Value-Based Healthcare: An Asian Perspective

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Credit: Pixabay
Credit: Pixabay

In conjunction with the 2nd Singapore International Public Health Conference, Medtronic, a global leader in medical technology held a symposium recently on “Value-Based Healthcare: A Global Assessment” that aimed to address the rising healthcare costs and unequal access.

The goal of value-based healthcare is to lower health care costs and improve quality and outcomes. For patients, this means safe, appropriate, and effective care with enduring results, at reasonable cost.  For healthcare providers, it means employing evidence-based medicine and proven treatments and techniques that take into account the patients’ wishes and preferences.

The global assessment, done by the Economist Intelligence Unit and commissioned by Medtronic, presented findings from different countries as their align their efforts in the shift towards value-based healthcare. This global assessment delivered country-level perspectives and actionable insights for applying the tenets of VBHC – including Australia, India, Indonesia, Japan and South Korea.

Expert panelists from the region, critically analyzed insights and discussed strategic plans to realize value-based healthcare in Asia-Pacific. The panel studied the region’s resistance and willingness to transform healthcare delivery systems that will result in improved patient outcomes and reduced cost.

Overview

Australia, Japan and South Korea have a moderate level of alignment with VBHC. Motivated by rising healthcare costs and the need to integrate and maximize current resources, these three countries have demonstrated readiness towards doing more on delivering value for patient-focused care. Of which, South Korea’s high-level and forward-thinking policy planning and implementation to enabling context for VBCH and measuring outcomes and costs gave the country a slight edge in Asia.

India and Indonesia showed low levels of alignment with VBHC. Healthcare efforts in these two countries are prioritized on improving basic infrastructure and increasing access to more of its population. However, both countries have unveiled early long-term policy planning that can realize increased patient care, access and quality.

Here is a snapshot of the Asia Pacific in-country evaluations on how organizations across the healthcare spectrum can partner to improve patient outcomes and optimize costs.

Australia

Australia has a mature healthcare system supported by highly skilled medical professionals and sophisticated healthcare coverage that results in excellent patient outcomes at comparatively low costs.

However, the implementation of VBHC in Australia is impeded by state administered payments and decentralized healthcare delivery systems. VBHC faces resistance from key stakeholders who focus on costs rather than value-based output, inversely causing high expenditure.

Australia’s key motivation to implement VBHC will be to lower healthcare costs. The country has already instigated a foundation for VBHC through a number of pilot projects. In addition, robust patient and consumer advocacy groups can help improve and accelerate the introduction of VBHC in Australia.

India

Due to a lack of infrastructure and policies needed to meet rising healthcare demands, 80 percent of the Indian population do not have access to basic healthcare services. India’s healthcare system is mainly characterized by high out-of-pocket payments (60 percent of total national health expenditure). There is also a large disparity in healthcare services between the rural and urban areas.

The government has attempted to transform the healthcare system with the primary aim of promoting access to affordable healthcare. With programs such as the National Rural Health Mission and the National Urban Health Mission, things have been set in motion to meet the objectives of the 12th Five Year Plan (2012 – 2017).

VBHC is part of the country’s broader quality standardization movement. The 2015 Draft National Health Policy promises reforms that will accelerate the adoption of VBHC. Notably, Fortis Healthcare, a private healthcare provider, received the 2014 Porter Prize for its efforts in implementing VBHC in India.

Indonesia

Indonesia introduced the National Health Insurance Program (JKN) in January 2014 to encourage usage rates of health services. However, the country faces varying levels of care, poor infrastructure, shortage of qualified medical professionals, funding disparities and inconsistent regulatory guidelines, affirming obstacles to implement a blanket universal coverage.

There has been initial development towards expanding health technology assessments and evidence-based medicine. The VBHC delivery model remains aspirational for Indonesia at this stage.

Japan

While VBHC is still under development in Japan, the government has been looking into ways they can address growing concerns over rising healthcare costs and an aging population.

A key milestone towards VBHC is the introduction of the Diagnosis Procedure Combination (DPC) in early 2000s to counteract fee-for-service systems. The integrated DPC payment system supports the improvements in healthcare standards and transparency. Hospital administrators and providers can access a database of objective treatment information, understand the outcomes related to the care they deliver and improve overall quality of care.

A part of Japan’s vision of healthcare policies includes the development of a healthcare system that is designed to maximize value attainable through current resources and value-based improvements in quality, while efficiency should be emphasized to deliver better care at lower costs.

South Korea

South Korea has one of the most sophisticated healthcare systems in Asia. There is a centralized system of universal healthcare coverage engaged to protect the whole population and various guidelines enforced by public offices.

South Korea’s health ministry showed a strong interest in adopting VBHC. Additionally, the country has established the Healthcare Big Data Hub in 2014 to provide patient records and information to all 87,000 healthcare institutions nationwide and to the public for free. There were however, some opposition from the medical community and privacy laws and regulations that have hampered the government’s efforts to develop a national electronic health record platform between 2005 and 2009.

South Korea remains in a good position to adopt VBHC in terms of healthcare system infrastructure and willing policy makers.

Source: The Economist