1.1 Introducing value-based healthcare

As an important and contemporary strategy, value-based healthcare operates on a sound evidence base and is a person-centred or consumer-centric approach that supports clinical decisions and governance to deliver value for patients in the form of health outcomes achieved per dollar spent (Porter & Teisberg, 2006). The approach requires significant system transformation, meaning change management and quality and safety considerations become of primary importance, along with ensuring that the evidence is available, supported and acted upon in any implementation scenario. Value-based healthcare aims to create better health outcomes with improved healthcare consumer experiences via planned care pathways that enhance the experience for health professionals providing the care and the general population served.

Value-based healthcare focuses on improving healthcare quality and safety for consumers (Dombradi et al, 2021) and preventing problems before they begin. Many value-based healthcare initiatives are conducted globally and in Australia, primarily focusing on acute healthcare settings. This leaves significant scope for implementation in other areas of the health and social care systems, including mental health, disability, aged care and community-based care. What seems problematic is that value-based healthcare requires coordination of effort and resources to achieve high-quality healthcare with outcomes acceptable to the consumer and clinicians.

An integrated team approach is inherent to robust value-based care models. The National Academy of Medicine defines team-based care as:

The provision of health services to individuals, families, or their communities by at least two health providers who work collaboratively with patients and their caregivers to the extent preferred by each patient to accomplish shared goals within and across settings to achieve coordinated, high-quality care. (Smith et al., 2018)

The team approach to care is linked to improved healthcare consumer outcomes and may also be a means to improve the wellbeing of the healthcare staff who provide the care (Welp & Manser, 2016). As care becomes increasingly complex and workforce availability becomes less assured, there are concerns that increased fragmentation will prevent the benefits of integrated care from being realised for consumers (Peikes et al., 2014).