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A Surgeon's Field Guide to Value-Based Specialty Care.
Willard C Harrill1,2,3,4,5, Frank G Opelka4,6, Mary L Witkowski7
1Carolina Ear Nose Throat-Sinus and Allergy Center. PA Hickory North Carolina USA.
Laryngoscope Investigative Otolaryngology
|August 27, 2025
Summary
Surgeons must adapt to value-based care by focusing on patient outcomes, engagement, and cost. A new framework, EM³ (Experience Management cubed), guides this transition for improved surgical performance and competitiveness.
Area of Science:
- Healthcare reform
- Surgical value-based care
Background:
- The healthcare industry is shifting from volume-driven fee-for-service to value-based accountable care.
- Current payment models inadequately align the surgeon-patient relationship, impacting patient engagement and outcomes.
Purpose of the Study:
- To review the conceptual shift towards value-based care in surgery.
- To clarify drivers of surgical value-based performance.
- To outline a strategy for engaging in healthcare reform.
Main Methods:
- Comprehensive literature search of PubMed/MEDLINE/Google.
- Inclusion of publications on value-based initiatives, administrative and government agency reports, and CMS/CMMI policies.
- Review conducted from June 1, 2024, to May 17, 2025.
Main Results:
- Value-based care necessitates a re-evaluation of how surgeons define and deliver care.
- A novel three-dimensional framework, EM³ (Experience Management cubed), is introduced to manage patient experience.
- EM³ focuses on clinical outcomes, patient engagement, and episode-of-care spend to optimize value (Value = Outcomes/Cost).
Conclusions:
- The EM³ framework provides a roadmap for operationalizing transparency and improving surgical value.
- It enhances surgical value-chain competency, team-based leadership, and longitudinal care management.
- Surgical specialties must develop new assessment measures and care plans incorporating EM³ to remain competitive in accountable care models.
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