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Improving Outcomes, Lowering Costs with Value-Based Care

Physicians looking at an x-ray.

What’s Happening

Dell Medical School is making a foundational, online curriculum in value-based health care available not only to its own students, but to learners across the country — preparing them to make efficient and effective decisions that provide value to their future patients.

Why It Matters

The United States spends much more on health care per capita than any other nation, but our health outcomes lag far behind the rest of the developed world.

There are many reasons for this value gap, but one cause that nearly all health care professionals — and patients — can help address is overuse. In health care, overuse is any treatment, test and procedure that does not make a patient healthier. For example, more than 40 percent of patients who receive antibiotics for upper respiratory infections do not need them. Overuse in this case puts patients at risk for adverse reactions to the antibiotics (such as allergic reactions or dangerous diarrheal illnesses) and also contributes to development of antibiotic-resistant bacteria, which cause at least 2 million illnesses and 23,000 deaths each year in the U.S.

Approximately one-third of health care costs are unnecessary, according to a report by the National Academy of Medicine. Since nearly every aspect of health care comes with some risks and downstream costs, the toll of overuse is patient harm, both physically and financially.

Value-based health care helps address how to make clinical decisions and design systems that focus on achieving better outcomes for patients and decreasing costs of care. However, most health professionals are not taught about the fundamentals of value-based health care or how to apply this framework in care delivery.

That’s why, in 2011, the Medicare Payment Advisory Commission deemed “high-value, cost-conscious care” a critical deficiency in medical education.

Scott Wallace and Elizabeth Teisberg.

Did You Know?

Dell Med is home to the Value Institute for Health and Care, which guides outcome and cost-measurement efforts at Dell Med and educates clinical and administrative leaders in various public and private health care organizations. It is led by Elizabeth Teisberg, Ph.D., and Scott Wallace, J.D., MBA.

Teisberg, who along with Michael E. Porter, Ph.D., wrote Redefining Health Care: Creating Value-Based Competition on Results and is the co-creator of the concept of value-based health care delivery.

How It Works

Discovering Value-Based Health Care, online instructional modules developed by a team led by Assistant Dean for Health Care Value Christopher Moriates, a national leader in high-value health care, are available to both Dell Med students and any learner with an interest in value-based health care.

The modules are a flexible tool. There is no need for a faculty expert to be available — students can learn in a workshop format or complete the modules on their own. The modules include topics such as introduction to health care value, delivery of health care value and improving value at bedside. Students learn about different types of outcomes that matter to patients, how to understand differences between charges and costs in health care, how different care models aim to improve value, communication techniques and more.

The conversation doesn’t end when users finish the curriculum: After completing the modules, 96 percent of Dell Med students reported discussing value-based health care with peers. Ninety-eight percent say they have thought about how to make value-based changes to health care systems.

People with a magnifying glass. Illustration.

Who Are the Learners?

In the first year, the module website was visited by 9,600 users representing all 50 states and eight foreign countries. The top three professions of users are medical student, resident physician and practicing clinical physician.

Summary

Medical costs continue to rise in the United States, while medical outcomes remain relatively poor for too many Americans. Dell Med’s focus on value-based health care addresses this issue in part by educating future doctors in Austin and around the world in high-value practices via online instruction.

Patients who receive high-value care achieve outcomes that matter to them. In the best cases, these outcomes may even come at lower cost.