Musings on value-based care (as a Canadian)
Value-based care is one of the most crucial concepts in healthcare today, in both the US and Canada.
But how do we define it? Atul Gawande penned an excellent article in the New Yorker several years ago which hits the main points in a very compelling way. Further, several years ago, the American Board of Internal Medicine (ABIM) Foundation launched the “Choosing Wisely” initiative in part to support value-based care and reduce wasteful procedures/treatments (including that which has little to no evidence of effect).
Value as it relates to ‘value based care’ (VBC) is defined as “the measured improvement in a person’s health outcomes for the cost of achieving that improvement.” It’s crucial to note that while reducing costs/waste is related to VBC, it can’t be equated to VBC — they aren’t the same thing.
This brings us to a more philosophical argument: what does “value” mean generally, and how does this concept apply to both our health, and the systems that support it (the obvious ‘healthcare system,’ but also the places we work and play and live)?
First we can ponder what value means to ‘health.’ We can probably agree that our ‘health’ is inherently valuable, as it’s derivative: without it we’re limited in actualizing our other core needs. As such, we place high value on our health, and are…
