Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 14 1 2025 12 01 Choosing to Implement Value-Based Healthcare Initiatives: A Strategic Decision for Achieving Better Performance in Improving Population Health; Comment on “Reflections on Managing the Performance of Value-Based Healthcare: A Scoping Review” 1 3 4728 10.34172/ijhpm.9050 EN Ana Paula Beck Da Silva Etges National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, Brazil PEV Healthcare Consulting, Porto Alegre, Brazil Programa de Pós-graduação em Epidemiologia da Escola de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil Journal Article 2025 02 22 <span class="fontstyle0">Operational effectiveness is about improving what is being done, reducing errors and harms, and improving efficiency, while strategy involves making decisions and choices. Implementing value-based healthcare (VBHC) also means matching previous strategies and performance literature to guide building sustainable organizations in healthcare businesses. This commentary paper explores answers for: What does it mean to have a high-performance, sustainable, and impactful health organization? By describing frameworks about leadership and social capital, this piece argues that the healthcare system’s sustainability involves making choices that set as a strategy implementing VBHC principles, cause implications on regulatory, organizational, and individual levels, and result in structuring systems that contribute to achieving high performance on improving population health. The argumentation suggests that achieving a high-performance, sustainable, and impactful health organization can be translated into positively impacting population health with financial accountability, and systems internal processes may serve as roads to achieve that impact on society.</span> https://www.ijhpm.com/article_4728_936658d5c2aa9f88409db4ac3bd2d2aa.pdf