As consumers, we make value-based decisions every day. At the grocery store, you're likely to consider food quality, quantity and your own personal tastes when selecting what goes in your basket. Higher-quality produce, for instance, typically costs more and whether better-quality items are worth the extra cost depends on how much you value them.
When it comes to our healthcare, however, not only are prices much less likely to be tied to value, but measuring value has proven to be challenging. Everyone—from patients to payers and health systems—is pouring dollars into a system with little-to-no visibility into the true value of what they are buying.
That's not to say some haven't tried to calculate value. There is widespread agreement that the U.S. healthcare system should reimburse based on value rather than volume. But while there is growing recognition that not all healthcare dollars are delivering equal value to consumers, the discussion around value in healthcare quickly becomes contentious because value is a matter of perspective; assessments of value differ from one context to the next.
In healthcare, different stakeholders have vastly different perceptions of value, with important implications for decisionmaking. An employer paying for healthcare may want to find solutions that decrease employee absences and prevent lengthy hospitalizations. A health insurer might prioritize reducing total costs in the short run, especially if it has frequent enrollee turnover. An insured patient—especially one of the increasing number of patients on high-deductible health plans—would likely care much more about out-of-pocket costs and impacts on their quality of life. The list goes on.
Every healthcare decision affects multiple stakeholders—most importantly, patients—but current value assessments tend to be conducted from a single perspective. There is currently no consensus on a scientifically credible and unbiased way to measure value in treatments and services. To make matters worse, current assessments of value often lack transparency, which makes it difficult to gauge accuracy or engage in constructive dialogue.
The Innovation and Value Initiative is working to change that.
In November 2017, the IVI launched the Open-Source Value Project to provide an objective, scientifically credible and truly collaborative way for all healthcare stakeholders to individually measure value in treatments and services. We've kicked off the project with a tool measuring value in treatments for rheumatoid arthritis, one of our nation's costliest chronic diseases. As its name indicates, the Open-Source Value Project uses an open-source modeling approach to measure treatment value. Like open-source software, all of our tools and models are freely available for use by everyone and are continually evolving based on user feedback.
Open-Source Value Project models serve as a hands-on laboratory for improving how we measure value because they are iterative, transparent, evidence-based and, most important, collaborative. We want anyone with a stake in healthcare–patients and their family members, physicians, health plans, researchers and even computer programmers–to try out the rheumatoid arthritis tool and tell us what you think. The IVI is accepting comments through Feb. 16.
The current version of IVI's value tool is just the beginning. While specific plans and exact timing are still being finalized, IVI aims to release one to two distinct models each calendar year. We are currently assessing opportunities for developing an open-source value tool for oncology, with other disease areas to follow. Through the transparent and collaborative process of developing these models, our goal is to build flexible and consensus-based tools to inform better decisionmaking in the U.S. healthcare system.
Consensus can emerge only through open and transparent collaboration. IVI welcomes involvement and viewpoints from all potential users of our work. With your help, we can find common ground and create a better healthcare system—one that rewards value instead of volume.
Mark Linthicum is director of scientific communications for the Innovation and Value Initiative, a not-for-profit collaboration between patient advocacy organizations, payers, providers and life sciences companies dedicated to improving the way value is measured and rewarded in healthcare.
