Abstract
ValueCare (2019-2024) was a project, funded by the Horizon2020, that was based on the implementation of the Value Based Healthcare (VBHC) model across Europe, delivering an efficient outcome-based integrated care for older people facing multiple chronic health conditions to improve their quality of life, as well as the sustainability of health and social care systems in Europe.
The basic assumption of the VBHC model, which foresees the involvement and empowerment of patients and their families from the very beginning and at all stages, is that the value of care is the results obtained and the patient's experience divided by the costs and energy used to achieve these results (Carman et al. 2013).
The oral presentation will aim (a) to highlight the process of applying the VBHC model (b) to show the results achieved in the 7 pilot sites supported by a scalable ICT solution and (c) to present the book, giving participants the opportunity to download it from the project website.
In applying the VBHC model, 2 basic criteria were considered (a) the entire care cycle and (b) the adoption of a time and activity-based costing system (TDABC) (Kaplan & Anderson, 2004) and inverse understanding value as the unit increase in investment, per citizen, required to stabilise or improve the given clinical condition. The healthcare practitioners’ experience component was included in the formula as an addendum to the variation in outcomes (Zanutto, Ceron & Haat, 2024) and was measured using the Metro mapping tool: a method for designing and optimising care pathways, devised by Ingeborg Griffioen.
The older people’s health outcomes were collected through self-reported questionnaires, which were developed on the ICHOM standards. Each pilot site had a different clinical condition and therefore could add additional evaluation questionnaires.
An important assumption in the project was the attempt to apply the 6 building blocks of Porter's agenda (Harvard Business School, Institute for Strategy and Competitiveness):
1. Organise in integrated care practice units (IPUs).
2. Measure outcomes & costs for every patient
3. Move to bundled payment for conditions
4. Integrate multi-site care delivery systems
5. Expand geographical reach
6. Build an integrated Information technology platform
It is mentioned as an attempt because the results showed that 3 blocks were applied: the creation of IPUs, the measurement of outcomes and costs, and the creation of an integrated technology platform. The application of the remaining ones is part of the project's sustainability plan.
In conclusion, the project proposed more efficient use of resources and coordination of care in a context that ensured the trust of users and policy makers on data access, protection and sharing and standardisation that can be replicated across the EU.
The project thus awarded VBHC certification by the VBHC Center Europe in Amsterdam and published its results in the book ‘The ValueCare experience: Creating value for older people with chronic conditions in Europe with a transition towards outcome-based integrated care supported by technology’ edited by Oscar Zanutto, Sara Ceron and Hein Raat in September 2024.