Article Figures & Data
Figures
- Fig 1.
Five-step value improvement cycle
Tables
- Table 1.
Porter and Lee's strategic agenda for moving to a high-value healthcare delivery system
Value agenda Examples of steps taken in response to the pandemic Organise care around medical conditions Populations were segmented based on risks associated with COVID-19 infection, allowing for tailored responses and prioritised resource allocation to maximise population-level outcomes Measure outcomes and costs Standardised results measurements were adopted and made transparent at the national and international level, enabling benchmarking and rapid adoption of new standards of care Move to bundle payments for care cycles Financial flexibility in provider payment was implemented, enabling fast service redesign and resource reallocation to improve COVID-19 care while meeting broader health and social needs Integrate care across separate facilities Greater collaboration happened across local health and care services, enabling fast service shifts affecting the whole care pathway Expand services across geographies New care models integrating acute, non-acute and digital care settings enabled fast expansion and continuity of care delivery through a broader range of delivery assets Build enabling IT platforms Health system data was consolidated, new health informatics systems were introduced and enhanced analytics were deployed that can support future development of value-based healthcare Overview
Acquired in 2015 by Medtronic, Diabeter is a group of certified clinics that specialise in providing comprehensive and individualised care for children and young adults with type 1 diabetes. In 2019, Diabeter cared for more than 2,400 patients in five locations across the Netherlands.
Solution
The Diabeter integrated care model works on Porter and Lee's value agenda and offers a holistic diabetes management solution focused on patient outcomes and cost reduction. The value-based model includes customised care pathways for different patient cohorts, four clinic visits per year, virtual consultations, clinical and administrative staff services, a 24-hour medical hotline, lab costs, a data platform and sensor equipment.
Outcome
The recommended glycated haemoglobin (HbA1c) target to avoid complications is 58 mmol/mol. At Diabeter, 55% of paediatric patients have HbA1c levels below that target compared with only 28% of the Dutch paediatric population. Diabeter patients also have 3% hospitalisation rates versus an average of 8% in the Netherlands. These results were achieved without increasing costs. The single condition focus and the commitment to employee satisfaction (when teams are empowered to apply their expertise to improve results, stress and burnout at work decline while patient satisfaction rises) empower Diabeter clinicians to remain concentrated on the full spectrum of patient needs, leading the group to consistently outpace the national averages for outcome data.
In 2019, Diabeter also closed a ground-breaking 10-year value-based healthcare partnership with Zilveren Kruis, the largest insurance company in the Netherlands. This is the first value-based agreement worldwide that includes short- and long-term complications for type 1 diabetes. The partnership is based on a shared ambition of a complication-free life for type 1 patients now and in the future, and at a minimal cost.
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- Article
- Abstract
- Introduction
- COVID-19 forces faster adoption of value-based healthcare
- Key tenets of value-based healthcare were implemented during the crisis
- Providers must capitalise on this momentum but will need to consider the challenges
- Post-crisis imperatives
- Best practices for value-based transformation
- Conclusion
- References
- Figures & Data
- Info & Metrics
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