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What does value mean? — U of Utah professor Dr. Robert Pendleton on value-based care

University of Utah Professor Robert Pendleton, MD, wrote a column for Harvard Business Review seeking to define value.

Here's what you should know:

1. Dr. Pendleton is awaiting Amazon, Berkshire Hathaway and JP Morgan Chase's entry into the marketplace to see if the businesses can "disrupt the U.S. healthcare system into consistently delivering high-value care."

2. He said the issue lies in what value actually means, citing a lack of progress in healthcare on a shifting, varying definition of value.

3.The University of Utah surveyed more than 5,000 patients, 600 physicians and 500 employers who provide medical benefits on what they think about quality, service and cost of healthcare. "What we discovered is that there are fundamental differences in how [parties] define value in healthcare and to whom they assign responsibility for achieving it," said Dr. Pendleton.

4. He argues value is a buzzword, used as a catchall depending on who is utilizing it.

5. Dr. Pendleton said the survey did clear up one thing. The best way to define value is to "stop, listen and learn," he added, "The most effective thing that stakeholders can do to create a high-value health care system is to pause in their independent pursuits of value to describe to each other exactly what it is they seek."

6. To do this, healthcare needs leaders in each sector to listen to constituents and agree that "the path toward value that we charted may not have been the right one."

7. The most concerning disconnect on value was present between patients and physicians, he said. The survey found a lack of consensus between the parties on who was responsible for facilitating value-based care, and both parties showed a limited understanding of how healthcare works beyond a participant's direct impact within the system.

8. He offered two methods to better define value:

  • Leverage the growing power of review systems to gather information on what's valued by healthcare consumers
  • Start bringing shareholders together to research and discuss value

9. As for the disruptive megamerger of Amazon, Berkshire Hathaway and JP Morgan Chase, Dr. Pendleton argues the companies should act as a mouthpiece to decree the benefits of value and to remind everyone "value means more than just what we pay," and that partnerships with providers are needed to enhance communication and implement review systems.

"Being the smart, creative, bold people [the companies' founders] are, they should help guide all stakeholders through the difficult compromises necessary to create a collective vision of a high-quality, patient-focused, cost-effective health care system," he said. "That would truly be disruptive."

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