1. Value Based Healthcare -A paradigm shift?
Hamish Laing
Professor of Enhanced Innovation, Engagement and Outcomes
School of Management, Swansea University

2. Health systems are facing huge challenges Five disruptive Forces in Combination
Greying patient (and provider)
Blessing and Curse of Technology
Rise of Chronic Disease
Information Revolution
New Health & Care Consumer
From Advisory Board

3. The challenge: Finances
Global and will be relentless until the paradigm changes
1)Assumes IMF, country-specific health care growth rates.
2)According to AIHW calculations.
3)New Zealand Ministry of Health projections.
Source: Cottarelli, C., “Macro-Fiscal Implications of Health Care reform in Advanced and Emerging Economies,” IMF Fiscal Affairs Department, December 2010; McKinsey & Company, “mHealth: A new vision for healthcare,” available at: Office of Economic Co-operation and development, OECD indicators available at

4. NHS Wales

6. A Healthier Wales: our Plan for Health and Social Care (2018)
The Quadruple Aim (4): “increase the value achieved from funding of health and care through improvement, innovation, use of best practice, and eliminating waste”. Ten Design Principles (7): “ Higher Value – achieving better outcomes and a better experience for people at reduced cost; care and treatment which is designed to achieve ‘what matters’ and which is delivered by the right person at the right time; less variation and harm”.

7. The “origins” of Value Based Healthcare

8. Value Based Healthcare (VBHc) Porter M and Lee T HBR
“ [Healthcare] Organizations understand that without a change in their model of doing business, they can only hope to be the last iceberg to melt….they have no choice but to improve value and be able to prove it. ” This applies to life-science industries too

9. Value Based Healthcare: what is it?
𝑉𝑎𝑙𝑢𝑒= 𝑂𝑢𝑡𝑐𝑜𝑚𝑒𝑠 𝑡ℎ𝑎𝑡 𝑚𝑎𝑡𝑡𝑒𝑟 𝑡𝑜 𝑝𝑎𝑡𝑖𝑒𝑛𝑡𝑠 𝐶𝑜𝑠𝑡 𝑜𝑓 𝑑𝑒𝑙𝑖𝑣𝑒𝑟𝑦 𝑡ℎ𝑒 𝑜𝑢𝑡𝑐𝑜𝑚𝑒𝑠
𝑉𝑎𝑙𝑢𝑒= 𝑂𝑢𝑡𝑐𝑜𝑚𝑒 𝐶𝑜𝑠𝑡
Porter, M et al. Harvard Business School

10. Measuring outcomes (that matter)
1 Tracked via the IBD-Control 2 Tracked via the Manitoba IBD Index

11. NHS Wales Developments
Lung Cancer
Heart Failure
Time Driven Activity Based Costing (TDABC) in progress

12. Health Boards activity
Parkinson’s Disease
Dementia
Inflammatory Bowel Disease
Cataracts
Vascular Surgery
Breast Surgery
Endoscopy
COPD
Primary care MH
Psoriasis
Hip Arthroplasty
Knee Arthroplasty
General Health EQ5D
Diabetes
Arthritis
Adult Autism
Alcohol Liaison
Tonsillectomy
Prostate Cancer
National PROM repository
National PROM application
Paper forms
UK Registries

13. Value Based Healthcare Comparing outcomes

14. Value Based Procurement
Placing Clinical and Patient Reported Outcomes at the heart of the procurement decision making process

15. VBHc and Health Tech Industries
Key success factors
Partnership and Trust between industry and NHS
Shared accountability for delivering outcomes
Measure outcomes at every stage
Deliver value through innovation
Create new business models and payment systems that align financial incentives to deliver value
Stop doing things that don’t deliver value
Blog

16. Outcomes and the pharmaceutical industry
The European Federation of Pharmaceutical Industries and Associations (EFPIA) represents around 1,900 pharmaceutical companies in Europe and is dedicated to improving health outcomes for patients and making European healthcare systems more sustainable through outcomes-based models based on measuring, comparing and incentivizing health outcomes.
Pharma partnering with ICHOM to understand outcomes from their technologies better
Pfizer investing in School of Management, Swansea University