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Bringing the value equation into play in value-based healthcare.
Borja García-Lorenzo1,2, Arantzazu Arrospide1,3, Iker Ustarroz-Aguirre4
1Biosistemak Institute for Health System Research, Bilbao, Basque Country, Spain.
Frontiers in Public Health
|April 29, 2026
Summary
This study introduces a new method to measure healthcare value, using patient outcomes and costs to compare providers. It offers a practical tool for value-based healthcare decision-making.
Area of Science:
- Healthcare Management
- Health Economics
- Medical Informatics
Background:
- Value-based healthcare (VBHC) aims to link health and economic outcomes but lacks a clear value equation.
- Estimating and interpreting the value equation is a significant challenge in practical VBHC implementation.
Purpose of the Study:
- To provide a methodological proof-of-concept for estimating healthcare value.
- To address the ambiguity in the current VBHC value equation.
Main Methods:
- A cohort of 330 breast cancer patients with 12-month follow-up was analyzed.
- Introduced patient-centred outcome-adjusted life years (PACELYs) combining patient-reported outcomes (PROs) and survival.
- Utilized a marginal perspective with Incremental Value (IV) and value curves for decision-making.
Main Results:
- Healthcare Centre B demonstrated higher efficiency, generating an additional PACELY at 376€ compared to Centre A.
- Value curves illustrated varying efficiency across different VBHC thresholds.
- Mean PACELYs ranged from 69.85 to 73.24, with costs between 12,129€-13,404€.
Conclusions:
- This study presents the first proof-of-concept for a patient-centered efficiency metric in VBHC.
- The proposed method, using PACELYs and a marginal perspective, transforms the value equation into a practical decision-making tool.
- The findings facilitate benchmarking and can be applied to other medical conditions, paving the way for value-based payment systems.
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