Reflections on Managing the Performance of Value-Based Healthcare: A Scoping Review

Document Type : Review Article

Authors

1 Nyenrode Business Universiteit, Breukelen, The Netherlands

2 Health Services Administration Department, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA

Abstract

Background 
Value-based healthcare (VBHC), which can be viewed as a strategy to organize and improve healthcare services, has far-reaching organizational and managerial consequences. It is common managerial practice to support the execution of a strategy by monitoring the ensuing activities. Such monitoring provides feedback and guidance on the execution of these activities to the management of an organization and helps to realize organizational strategies. Monitoring of activities is commonly done by performance management systems. Given the rising attention in the literature and in practice for VBHC, we ask to what extent VBHC is supported by performance management systems in practice, and how we can explain what we find to support further successful implementation of VBHC.

Methods 
In our scoping review of financial and performance management at the organization or unit-level of healthcare organizations that apply value-based approaches, we identified 1267 unique papers in Embase, Medline, OVID, and Web of Science. After the (double-blinded) title and abstract screening, 398 full-text articles were assessed for further analysis.

Results   
Our review reveals only eleven original papers discussing specifically the integration of VBHC and performance management systems. Almost all the featured applications in these papers focus on a specific project or medical specialty. Only one paper exemplifies how VBHC has been integrated with the performance management systems of a medical institution, and no paper provides a clear link with strategy execution. We ask why this is the case and propose several explanations by studying the extant performance management literature. We see these explanations as issues for further reflection for VBHC practitioners and researchers.

Conclusion 
We conclude that one of the reasons for the absence of papers integrating VBHC and performance management systems is formed by the tensions that exist between striving for “the best care” or even for providing “all care that is viably possible” and pursuing greater (financial) efficiency. Implementing VBHC as an important organizational strategy and explicating this strategy in the performance management systems requires that these tensions need to be brought into the fore. When this is not done, we believe that VBHC adoptions that are fully integrated with performance management systems will remain limited in practice.

Keywords

References

  1. World Health Organization (WHO). Global Spending on Health: A World in Transition. Geneva, Switzerland: WHO; 2019.
  2. Porter ME, Teisberg EO. Redefining competition in health care. Harv Bus Rev. 2004;82(6):64-76.
  3. Porter ME, Teisberg EO. Redefining Health Care: Creating Value-Based Competition on Results. Boston: Harvard Business School Press; 2006.
  4. Zanotto BS, da Silva Etges APB, Marcolino MAZ, Polanczyk CA. Value-based healthcare initiatives in practice: a systematic review. J Healthc Manag. 2021;66(5):340-365. doi:1097/jhm-d-20-00283
  5. Burke T. Accountable care organizations. Public Health Rep. 2011;126(6):875-878. doi:1177/003335491112600614
  6. Triple Aim for Populations. Institute for Healthcare Improvement; 2022. Available from: http://www.ihi.org/Topics/TripleAim/Pages/default.aspx. Accessed March 22, 2022.
  7. Naessens JM, Van Such MB, Nesse RE, et al. Looking under the streetlight? A framework for differentiating performance measures by level of care in a value-based payment environment. Acad Med. 2017;92(7):943-950. doi:1097/acm.0000000000001654
  8. Kahn CN 3rd, Ault T, Potetz L, Walke T, Chambers JH, Burch S. Assessing Medicare's hospital pay-for-performance programs and whether they are achieving their goals. Health Aff (Millwood). 2015;34(8):1281-1288. doi:1377/hlthaff.2015.0158
  9. van der Nat PB, van Veghel D, Daeter E, et al. Insights on value-based healthcare implementation from Dutch heart care. Int J Healthc Manag. 2020;13(3):189-192. doi:1080/20479700.2017.1397307
  10. Simons R. Performance Measurement and Control Systems. Upper Saddle River, NJ: Prentice Hall; 2000.
  11. Walker RM, Damanpour F, Devece CA. Management innovation and organizational performance: the mediating effect of performance management. J Public Adm Res Theory. 2011;21(2):367-386. doi:1093/jopart/muq043
  12. Otley D. Performance management: a framework for management control systems research. Manag Account Res. 1999;10(4):363-382. doi:1006/mare.1999.0115
  13. Broadbent J, Laughlin R. Performance management systems: a conceptual model. Manag Account Res. 2009;20(4):283-295. doi:1016/j.mar.2009.07.004
  14. van Veghel D, Schulz D, Soliman-Hamad M, Dekker L. The need for new financial models in the implementation of value-based healthcare. Int J Healthc Manag. 2021;14(2):345-348. doi:1080/20479700.2019.1647377
  15. Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18(1):143. doi:1186/s12874-018-0611-x
  16. Boland A, Cherry MG, Dickson R. Doing a Systematic Review. 2nd ed. Los Angeles: SAGE Publications; 2017.
  17. Parra E, Arenas MD, Alonso M, et al. Assessing value-based health care delivery for haemodialysis. J Eval Clin Pract. 2017;23(3):477-485. doi:1111/jep.12483
  18. Reilly CA, Doughty HP, Werth PM, Rockwell CW, Sparks MB, Jevsevar DS. Creating a value dashboard for orthopaedic surgical procedures. J Bone Joint Surg Am. 2020;102(21):1849-1856. doi:2106/jbjs.20.00270
  19. Robinson JR, Carter NH, Gibson C, et al. Improving the value of care for appendectomy through an individual surgeon-specific approach. J Pediatr Surg. 2018;53(6):1181-1186. doi:1016/j.jpedsurg.2018.02.081
  20. Van Den Berg K, Dijksman LM, Keus SHJ, Scheele F, Van Pampus MG. Value-based health care in obstetrics. J Eval Clin Pract. 2020;26(1):101-108. doi:1111/jep.13208
  21. Winegar AL, Jackson LW, Sambare TD, et al. A surgeon scorecard is associated with improved value in elective primary hip and knee arthroplasty. J Bone Joint Surg Am. 2019;101(2):152-159. doi:2106/jbjs.17.01553
  22. Zipfel N, Groenewoud AS, Rensing B, et al. Selecting interventions to improve patient-relevant outcomes in health care for aortic valve disease - the Intervention Selection Toolbox. BMC Health Serv Res. 2020;20(1):232. doi:1186/s12913-020-05090-z
  23. Bonde M, Bossen C, Danholt P. Translating value-based health care: an experiment into healthcare governance and dialogical accountability. Sociol Health Illn. 2018;40(7):1113-1126. doi:1111/1467-9566.12745
  24. Côté-Boileau É, Breton M, Denis JL. Control rooms in publicly-funded health systems: reviving value in healthcare governance. Health Policy. 2021;125(6):768-776. doi:1016/j.healthpol.2021.04.007
  25. Feitz R, van Kooij YE, Ter Stege MHP, et al. Closing the loop: a 10-year experience with routine outcome measurements to improve treatment in hand surgery. EFORT Open Rev. 2021;6(6):439-450. doi:1302/2058-5241.6.210012
  26. Nycz G, Shimpi N, Glurich I, et al. Positioning operations in the dental safety net to enhance value-based care delivery in an integrated health-care setting. J Public Health Dent. 2020;80 Suppl 2:S71-S76. doi:1111/jphd.12392
  27. van der Nat PB, Derks L, van Veghel D. Health outcomes management evaluation-a national analysis of Dutch heart care. Eur Heart J Qual Care Clin Outcomes. 2022;8(6):670-680. doi:1093/ehjqcco/qcab060
  28. Keel G, Savage C, Rafiq M, Mazzocato P. Time-driven activity-based costing in health care: a systematic review of the literature. Health Policy. 2017;121(7):755-763. doi:1016/j.healthpol.2017.04.013
  29. Reitblat C, Bain PA, Porter ME, et al. Value-based healthcare in urology: a collaborative review. Eur Urol. 2021;79(5):571-585. doi:1016/j.eururo.2020.12.008
  30. O'Boyle EH, Rutherford MW, Banks GC. Publication bias in entrepreneurship research: an examination of dominant relations to performance. J Bus Ventur. 2014;29(6):773-784. doi:1016/j.jbusvent.2013.10.001
  31. Olaison L, Sørensen BM. The abject of entrepreneurship: failure, fiasco, fraud. Int J Entrep Behav Res. 2014;20(2):193-211. doi:1108/ijebr-09-2013-0143
  32. Lane A, Mallett O, Wapshott R. Failure and entrepreneurship: practice, research, and pedagogy. J Small Bus Entrepreneurship. 2019;31(1):97-99. doi:1080/08276331.2018.1518072
  33. Pereira V, Gabriel MH, Unruh L. Multiyear performance trends analysis of primary care practices demonstrating patient-centered medical home transformation: an observation of quality improvement indicators among outpatient clinics. Am J Med Qual. 2019;34(2):109-118. doi:1177/1062860618792301
  34. Hopwood AG. Accounting and everyday life: an introduction. Account Organ Soc. 1994;19(3):299-301. doi:1016/0361-3682(94)90037-x
  35. Letiche HK. Making Healthcare Care: Managing Via Simple Guiding Principles. Information Age Publishing; 2008. p. 300.
  36. Zuurbier JJ. Financial Control in Hospitals: The Changing Structure of Internal Financial Control in Dutch Hospitals [dissertation]. Enschede: University of Twente; 1994.
  37. Vosselman E. The ‘performativity thesis’ and its critics: Towards a relational ontology of management accounting. Account Bus Res. 2014;44(2):181-203. doi:1080/00014788.2013.856748
  38. Zimmerman J. Accounting for Decision Making and Control. 10th ed. London: McGraw-Hill Education Europe; 2020.

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History

  • Receive Date: 25 May 2022
  • Revise Date: 25 October 2022
  • Accept Date: 07 April 2023
  • First Publish Date: 08 April 2023

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