Abstract
Background: The Tan Tock Seng Hospital (TTSH) Value Programme Evaluation Framework addresses the pressing need for a value-based healthcare approach, particularly due to an aging population and rising healthcare costs. The evaluation framework assesses the maturity of various value-based programs at TTSH across four components: Care and Service Design, Outcomes, Cost and Payments, and Data.
Approach: The evaluation framework defines a value program as an initiative that directly delivers value to patients. Programs are assessed based on four components of value-based care: Care and Service Design, Outcomes, Cost and Payments, and Data. The framework draws inspiration from the Institute of Healthcare Improvement’s Triple Aim and Professor Michael E. Porter’s Strategic Agenda.
Each programme is scored on a scale of 0 to 3 for each component, with an aggregated score determining its maturity level. The evaluation process includes the development of each programme’s report, validating the information with programme owners, identifying opportunities for improvement, and providing recommendations. This systematic approach aims to create a feedback loop for hospital leaders and program owners to enhance value-based care delivery.
In addition, this evaluation provides system-level improvement recommendations for the hospital as a whole, to advise on areas to strengthen the enablers for value-based care.
Results: Out of the 33 evaluated programs, 42% were identified as intermediate/developing, while 58% were fairly mature. Key insights revealed that most programs had detailed inpatient service designs but lacked comprehensive care beyond TTSH. Outcomes were primarily tracked in inpatient settings, with limited sharing of results with partners. Cost evaluations were outdated, and data collection processes were insufficient, with many programs ceasing manual data collection. The evaluation highlighted significant gaps in costing, payment models, and data infrastructure, prompting the need for targeted recommendations to improve programme effectiveness and alignment with value-based care principles.
Implications: The Value Programme Evaluation Framework provides a comprehensive overview of TTSH's key programs' maturity and alignment with value-based care. It enables hospital management to identify strengths and areas for improvement, fostering a culture of value-based care. While the framework offers qualitative insights, it should be complemented with quantitative measures to assess the effectiveness of programs in care delivery and cost. The evaluation's findings underscore the importance of enhancing data infrastructure and revising cost models to support value-based care initiatives. As TTSH continues its journey towards value-based healthcare, the framework serves as a vital tool for driving improvements and ensuring sustainable healthcare delivery.