Value based health care – Already here, but still a long journey to connect to payments
20 Dec 2016

In a recent report by the Economist, Sweden was pointed out as the leading country in the world in terms of being prepared for value based health care (VBHC). Click here to see the report.

The high quality patient registries in Sweden and the history of physician driving improvements of patient care provides a very valuable framework for value based health care. There are multiple examples of how this have led to improved patient outcomes.

A project was initiated 2013 in Sweden to address the questions of “Value based payments and monitoring of health care”. The project includes 7 county councils and many other stakeholders. The project has looked in to the following disease areas:

  • Breast Cancer
  • Diabetes
  • Maternity care
  • Hip and knee surgery
  • Obesity surgery
  • Spine surgery
  • Stroke

The project has been able to establish relevant systems to integrate data from several sources including the patient registries to enable a better monitoring of the relevant outcomes from a value perspective.

We recently interviewed all the counties involved in the project to understand their perspective of implementing the monitoring and payment models from this project.

All of them are interested to use the monitoring of outcomes to better understand the delivered care. None of them are actively planning to broadly implement methods of payments in relation to VBHC. Stockholm has previously successfully introduced a value based payment system for hip, knee and spine surgery. Västra Götaland (Gothenburg region) is making a small evaluation of a system to connect payments to VBHC.

Even though there is good progress do develop methods to monitor healthcare, it is still a long way to change the payment systems.