Development of a Tool to Assess the Implementation and Perception of the Value-Based Healthcare Model: Our Results

A successful implementation of VBHC requires significant transformations, spanning from structural adjustments to a fundamental shift in organizational culture. However, organizations often adopt VBHC principles piecemeal, while managers overlook diverse staff reactions and their leadership role. To address these challenges, we developed and validated a multi-source assessment tool for use by organizations during their transition to VBHC to determine whether they are progressing effectively in both the dimensions.

To develop the first version of the tool, a multidisciplinary group translated strategies identified in a previous scoping review into questionnaire items through structured sessions. To validate it, a two round Delphi analysis was conducted. Experts in VBHC, management, health economy and clinical/researcher were contacted to ask for their participation. Consensus was established based on the following criteria: a median (Mdn) score of ≥4, an interquartile range (IQR) of ≤1.5 or ≤2, and a frequency of ratings in the range [4-5] ≥ 70%.

A total of 54 experts were invited to participate in the Delphi survey. The first round received 25 responses, while the second round had 23 responses. The final version of the assessment tool consists of 30 questions divided into two macro-areas: the Value Agenda Section and the Change Management Section. All items achieved a minimum frequency of ratings > 80% during both the rounds.

By comparing the perspectives of managers and clinicians, the resulting tool enables organizations to assess the adoption of the Value Agenda component, as well as the change management strategies supporting its implementation.