Value-based health care is more than a concept. It is a rapidly emerging practice to transform health care and make it more sustainable by improving outcomes while maintaining or lowering total costs. BCG helps health care organizations adopt this transformative model.
Health care systems have a value problem, and the usual solutions—such as cost containment—are not solving it. For more than a decade, our value-based health care consulting experts have worked with health care innovators to help organizations develop cutting-edge value-based health care strategies in order to improve patient outcomes while maintaining or lowering total costs.
Health outcomes vary widely across hospitals, regions, and countries. And this holds true irrespective of the amount of money invested in the systems: those that spend the most money do not necessarily provide the best care. There is growing evidence that a substantial portion of health care spending is, quite simply, wasted on avoidable medical complications or medically unnecessary treatments.
To address these problems, industry leaders have begun to embrace value-based health care. Health systems around the world are systematically collecting, sharing, and analyzing health outcome data by disease group and population segment. By making this data standard and transparent, clinicians can benchmark and compare performance across care sites, document variations in health outcomes, identify best practices, and steer resources toward interventions and practices that have the highest value for patients. At BCG, we believe this value-based approach is the best way both to improve the quality of care and to curb excess health care spending.
By focusing on—and tracking—the health outcomes that matter most to patients, health care organizations achieve many benefits:
Our Center for Health Care Value offers tailored solutions to organizations seeking to adopt value-based health care. The Center draws on the firm’s extensive experience in developing and implementing value-based solutions for organizations across the health care value chain, including providers, payers, systems and services; biopharma; and medtech.
Dutch hospitals make value-based health care work. A Dutch network of seven leading teaching hospitals adopted a value-based health care approach that achieved reductions of nearly 30% in unnecessary inpatient stays and up to 74% in the rate of reoperation due to complications in breast cancer patients. They achieved this in a year and a half by emphasizing transparency and making value delivered to patients the core of its strategy.
European payer optimizes patient journey. A European payer wanted to improve health outcomes and reduce costs by optimizing the end-to-end patient journey. Using BCG’s Patient Finder platform, the company accessed real-time, interactive analytics to map patient journeys, build prediction models, and identify use cases with a total value of €300 million in potential cost reductions.
Health care systems assess their value-based health care maturity. Two state governments in Australia wanted to evaluate their readiness for value-based health care. We assessed their maturity, benchmarked performance in comparison with global competitors, and prepared the health care systems to continue their transition to a value-based health care model.
Medtech manufacturer develops value-based health care dashboard. A global medtech manufacturer wanted to assess its impact in value-based health care across key countries and regions. We delivered a comprehensive view of the company’s maturity and impact in value-based health care, identified near-term opportunities, and created a dashboard to track the full portfolio over time.
Multinational pharmaceutical company maps out future scenarios. A multinational pharma company wanted to forecast the evolution of value-based health care over the next ten years. We worked with the company to identify emerging trends, outline four distinct scenarios and their implications, and prioritize several no-regret moves.
We have partnered with pioneering organizations to uncover value-based health care insights and drive a common agenda for change.
Our value-based health care consultants use a variety of proven benchmarks, tools, and frameworks to help track and drive progress toward value-based health care. Examples include:
Our Value-Based Health Care Maturity Assessment Framework measures the progress of different countries or health care systems as they work to deliver greater value in health care.
BCG’s Hospital Suite compiles hospital metrics across regions to facilitate global health care benchmarking in such areas as hospital infrastructure, performance, finance, quality, and contracts.
Facing rising healthcare costs and complex claims, a growing number of agencies are shifting to value-based care, improving outcomes, transforming operations, and achieving sustainable financial results. This report outlines key pillars and practical advice for adopting this approach.
BCG experts discuss how COVID-19 created the needed urgency for measuring population outcomes through predictive-preventive health care.
Biopharma and medtech companies that adopt a digital-native approach can generate better outcomes, lower costs, and greater customer satisfaction.
The workforce shortage is rooted in employee burnout and inefficient care.
How can health systems deliver patient-centered, value-based care worldwide? To answer this question, BCG experts Stefan Larsson, Jennifer Clawson, and Josh Kellar (with Robert Howard) examine powerful case studies of public and private innovators in high- and low-income countries alike. The Patient Priority is designed as a practical step-by-step guide for clinicians, payers, and policymakers to put these ideas into action.
Contact The Patient Priority team to learn more
Our value-based health care consultants partner with leading companies to develop solutions in outcome measurement, health registries, value-based medical care, value-based payment models, value-based reimbursement in health care, value-based agreements, and more.
