The Department of Veterans Affairs launched a value management system to bridge the gap between fee-for-service and value-based care.

To fix broken US healthcare system, deliver value, VA director says

By Tom Sullivan
03:44 PM

BOSTON -- Veterans Affairs director of value management Nathan Tierney said that focusing on outcomes, rather than cost, is the key to improving healthcare.

“We know the healthcare system is broken,” Tierney said at the Pop Health Forum in Boston Tuesday.

Tierney listed the global aging population, growing affluence, a rise in chronic diseases and more informed patient populations as all “contributing to a rising demand for healthcare that’s just not sustainable.”


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To address those obstacles, the VA implemented a value management approach that defines value as the health outcomes that matter most to patients. And Tierney recommended that hospitals establish internal value management offices, even if only with a small number of people to start.

Half of providers and insurers are looking to switch to a value-based model and 67 percent of those said that half of their contracts will be value-based, Tierney said.

The VA views its value management as the bridge from the old world of fee-for-service to a new world of value-based care, he said, adding that it takes reinvesting in new ways to achieve strategic organizational goals.

Value management also must be transparent. At the VA, that means hosting a website that patients can go to and get a value score for free. Physicians can use the site to see their performance, and the VA intends to add new features in the coming months to enable patients to learn more about their condition.

“Value for patients should be the overarching theme,” Tierney said. “If we focus more on outcomes and less on cost we could actually improve the broken healthcare system in this country.”


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