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Value-Based Health Care in Hand Surgery: Where Are We & Where Do We Go From Here?
David N Bernstein1, Ryan P Calfee2, Warren C Hammert3
1Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Boston, MA; Institute for Strategy & Competitiveness, Harvard Business School, Boston, MA.
Abstract:
Health care delivery is broken. The cost of care continues to skyrocket and the outcomes most important to patients are often a mystery. Further, care is often delivered via a fee-for-service model where surgeons are rewarded for the quantity, not the quality, of services provided. Such a health care delivery system is not sustainable and does not incentivize stakeholders to focus on the most important element of the health care delivery "puzzle": the patient. Fortunately, we are in the midst of transforming our health care delivery system, with a focus on optimizing the value of care delivery (ie, health outcomes achieved per dollar spent across a full care cycle). In hand surgery, progress has been made as part of this health system evolution. However, there remains much to accomplish. In this article, the authors review the 6 components of a strategic agenda for moving to a high-value health care delivery system for hand surgery, focusing on where we are today and where we need to go from here.
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