Value-based healthcare in the midst of the COVID-19 pandemic response

Overview

The COVID-19 pandemic continues. In midst of this worldwide health crisis, the Global Innovation Hub for Improving Value in Health gathered lessons from its membership on how value-based healthcare policies and practices were informing the pandemic response in different countries. How were the pressures of the emergency being balanced against the need to sustain health system reform, and pursuit of other pressing system objectives (such as patient-centricity, access, quality and value for money)? Although its long-term effects are yet to be seen, it is worthwhile now to anticipate the pandemic’s impact on national initiatives on value: what is being impeded or delayed by the pandemic, and what is being accelerated?

The Hub analyzed contributions from twelve member countries. Globally, the pandemic starkly highlighted existing fragilities in health systems, and shifted national policy priorities. In this report, Value-based health care in the midst of the COVID-19 pandemic response, impacts on health policy for value were assessed across seven topics: the case for change; financing and payment models; digital health, data and measurement; evidence-based practice, standards and guidelines; quality, safety and operational improvement; workforce, culture and capability; patient and citizen engagement.

The report finds that the case for the widespread adoption of value-based healthcare was becoming stronger and more urgent as the pandemic continued. While some additional flexibilities and innovations in payment mechanisms were seen, there was also evidence of the suspension of some new payment models and reversion to block payments and fee-for-service. There was a substantial acceleration in digital health activities, and evidence that care standards and guidelines could developed and adopted at much greater pace than policymakers previously thought possible. Long-term impacts on quality, safety, workforce and culture remain to be determined. Much “business-as-usual” operation improvement and training were suspended while beneficial short-term operational flexibilities were put in place. Finally, consideration should be given to how the relationship between citizens and their health systems will be impacted by the pandemic. The opportunity to reimagine this relationship in the future to deliver better value for all should be seized. Insights and national experiences shared in this report will be of interest to all healthcare policymakers involved in shaping the recovery of their health systems from the pandemic, now and over the coming years.