Health Value Added (HVA): linking strategy, performance, and measurement in healthcare organizations

This paper describes "Health Value Added"--an innovative model that links performance measurement to strategy in health maintenance organizations. The HVA model was developed by Maccabi Healthcare Services, Israel's second largest HMO, with the aim of focusing all its activities on providing high quality care within budgetary and regulatory constraints. HVA draws upon theory and practice from strategic management and performance measurement in order to assess an HMO's ability to improve the health of its members. The model consists of four interrelated levels--mission, goals, systems, and resources--and builds on the existence of advanced computerized information systems that make comprehensive measurements available to decision makers in real time. HVA enables management to evaluate overall organizational performance as well as the performance of semi-autonomous units. In simple terms, the sophisticated use of performance measures can help healthcare organizations obtain more health for the same money.