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Article
Publication date: 10 August 2020

Daniel J. Rees, Victoria Bates, Roderick A. Thomas, Simon B. Brooks, Hamish Laing, Gareth H. Davies, Michael Williams, Leighton Phillips and Yogesh K. Dwivedi

The UK Government-funded National Health Service (NHS) is experiencing significant pressures because of the complexity of challenges to, and demands of, health-care

Abstract

Purpose

The UK Government-funded National Health Service (NHS) is experiencing significant pressures because of the complexity of challenges to, and demands of, health-care provision. This situation has driven government policy level support for transformational change initiatives, such as value-based health care (VBHC), through closer alignment and collaboration across the health-care system-life science sector nexus. The purpose of this paper is to evaluate the necessary antecedents to collaboration in VBHC through a critical exploration of the existing literature, with a view to establishing the foundations for further development of policy, practice and theory in this field.

Design/methodology/approach

A literature review was conducted via searches on Scopus and Google Scholar between 2009 and 2019 for peer-reviewed articles containing keywords and phrases “Value-based healthcare industry” and “healthcare industry collaboration”. Refinement of the results led to the identification of “guiding conditions” (GCs) for collaboration in VBHC.

Findings

Five literature-derived GCs were identified as necessary for the successful implementation of initiatives such as VBHC through system-sector collaboration. These are: a multi-disciplinarity; use of appropriate technological infrastructure; capturing meaningful metrics; understanding the total cycle-of-care; and financial flexibility. This paper outlines research opportunities to empirically test the relevance of the five GCs with regard to improving system-sector collaboration on VBHC.

Originality/value

This paper has developed a practical and constructive framework that has the potential to inform both policy and further theoretical development on collaboration in VBHC.

Details

Transforming Government: People, Process and Policy, vol. 15 no. 1
Type: Research Article
ISSN: 1750-6166

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Article
Publication date: 10 May 2018

Joseph M. Woodside

The purpose of this paper is to identify the underlying metaphors that hospitals use to establish their organizational mission. Metaphors impact the direction and…

Abstract

Purpose

The purpose of this paper is to identify the underlying metaphors that hospitals use to establish their organizational mission. Metaphors impact the direction and managerial decision making of organizations, and provide a method to more easily communicate to a variety of stakeholders.

Design/methodology/approach

A text analytics process is run to evaluate the mission statements from the largest hospitals by revenue in each of the 50 states of the USA and District of Columbia to identify the types of metaphor-based organizational health management methods.

Findings

A cluster analysis is generated to evaluate primary mission-based metaphors, and metatriangulation is used to evaluate output, develop theory and provide practical implications for healthcare management.

Originality/value

Key contributions include a review of healthcare metaphors, an analysis for understanding commonly utilized metaphors, a theory building process for developing a new integrated value-based care management metaphor, and a value-based process is developed for providing healthcare managers an easy to follow and repeatable process for improving organizational communication.

Details

Journal of Health Organization and Management, vol. 32 no. 3
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 13 July 2015

Riya Elizabeth George, Nisha Dogra and Bill Fulford

The purpose of this paper is to review the challenges of teaching values and ethics in mental-health, explore the differing perspectives of the key stakeholders and…

Abstract

Purpose

The purpose of this paper is to review the challenges of teaching values and ethics in mental-health, explore the differing perspectives of the key stakeholders and stimulate further questions for debate in this area; leading to a proposal of an alternative approach to educating mental-health professionals on values and ethics.

Originality/value

In current mental-health care settings, very few professionals work with homogeneous populations. It is imperative that mental-health education and training ensures health professionals are competent to practice in diverse settings; where ethics and values are bound to differ. Establishing professional practice not only involves considering concepts such as values and ethics, but also equality, diversity and culture. Incorporating values-based practice and cultural diversity training holds promise to education and training, that is truly reflective of the complexity of clinical decision making in mental-health. Further research is needed as to how these two frameworks can be unified and taught.

Details

The Journal of Mental Health Training, Education and Practice, vol. 10 no. 3
Type: Research Article
ISSN: 1755-6228

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Article
Publication date: 15 January 2021

Fiorella Pia Salvatore, Simone Fanelli, Chiara Carolina Donelli and Michele Milone

This study aims to analyze the value-based health-care model in defining a strategy to guide the evolution of health-care organizations toward a value-oriented model. To…

Abstract

Purpose

This study aims to analyze the value-based health-care model in defining a strategy to guide the evolution of health-care organizations toward a value-oriented model. To improve the quality of care by ensuring economic sustainability, it is necessary to redefine the concept of competition in healthcare and align it with the concept of maximizing value for patients.

Design/methodology/approach

Performance measurement is a crucial aspect of the analysis of health-care organizations. Porter developed an effective analytical technique and presented the measurement of health-care outcomes based on health conditions, the efficiency of health-care organizations and the type of service provided.

Findings

Clinical outcomes and data on the costs of care of each patient are essential to evaluate improvement in treatment value over time. Engaging in the evaluation of what happens to patients in their course of care enables the expansion of the measurement of outcomes because it measures all the health services related to it.

Originality/value

Building a health-care system based on the value and continuous improvement of care and services provided is a goal shared by many countries and international organizations. Today, the analysis of outcomes is important for making informed decisions, directing and planning clinical and organizational changes by improving the quality of care and services.

Details

International Journal of Organizational Analysis, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1934-8835

Keywords

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Article
Publication date: 29 April 2020

Tatiana Cornell

The purpose of this paper is to identify the primary executive leadership skills required to promote the effectiveness of Medicare Shared Savings Program Accountable Care

Abstract

Purpose

The purpose of this paper is to identify the primary executive leadership skills required to promote the effectiveness of Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs) and to create a new substantive theory describing these skills. The author identifies that MSSP ACO is a relatively new value-based care delivery (VBCD) structure in the USA that links clinicians’ compensation to their clinical outcomes. The research question concerns what primary executive leadership skills are essential in the VBCD era.

Design/methodology/approach

This single, embedded, exploratory case study is based on interviews, a focus group discussion and archival record data of MSSP ACO executives in the Northeast, Midwest, South and West of the USA.

Findings

The findings represented seven major categories or the primary executive leadership skills required to succeed in the VBCD environment. Each category or skill included five subcategories or concepts supporting the leadership skills essential for reaching VBCD goals. The categories and subcategories gave rise to a new substantive theory – the Accountable Healthcare Leadership Theory of Five Ps: promoting partnership between providers, patients and payers.

Research limitations/implications

The empirical generalizability of the results was limited by its essence as a single, embedded, exploratory case study of 18 MSSP ACO executives in 4 regions of the USA. The strength of this study, however, lies in its potential for making analytic generalizations for identifying theoretically meaningful leadership skills essential for success in the VBCD era.

Originality/value

The author has developed and validated a new theory describing the primary executive leadership skills required to succeed in the VBCD environment.

Details

Leadership in Health Services, vol. 33 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

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Article
Publication date: 19 June 2017

Christian Colldén, Ida Gremyr, Andreas Hellström and Daniella Sporraeus

The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The…

Abstract

Purpose

The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The purpose of this paper is to construct a taxonomy that supports the management of parallel IAs in healthcare.

Design/methodology/approach

Based on previous research, this paper proposes a taxonomy that includes the dimensions of view on value and organizational focus; three contemporary IAs – lean, value-based healthcare, and patient-centered care – are related to the taxonomy. An illustrative qualitative case study in the context of psychiatric (psychosis) care is then presented that contains data from 23 interviews and focuses on the value concept, IAs, and the proposed taxonomy.

Findings

Respondents recognized the dimensions of the proposed taxonomy and indicated its usefulness as support for choosing and combining different IAs into a coherent management model, and for facilitating dialog about IAs. The findings also suggested that the view of value as “health outcomes” is widespread, but healthcare professionals are less likely than managers to also view value as a process.

Originality/value

The conceptual contribution of this paper is to delineate some important characteristics of IAs in relation to the emerging “value era”. It also highlights the coexistence of different IAs in healthcare management practice. A taxonomy is proposed that can help managers choose, adapt, and combine IAs in local management models.

Details

Journal of Health Organization and Management, vol. 31 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 25 October 2017

Kerstin Nilsson, Fredrik Bååthe, Annette Erichsen Andersson and Mette Sandoff

The aim of this study has been to explore learning experiences from the two first years of the implementation of value-based healthcare (VBHC) at a large Swedish…

Abstract

Purpose

The aim of this study has been to explore learning experiences from the two first years of the implementation of value-based healthcare (VBHC) at a large Swedish University Hospital.

Design/methodology/approach

An explorative design was used in this study. Individual open-ended interviews were carried out with 19 members from four teams implementing VBHC. Qualitative analysis was used to analyse the verbatim transcripts of the interviews.

Findings

Three main themes pinpointing learning experiences emerged through the analysis: resource allocation to support implementation, anchoring to create engagement and dedicated, development-oriented leadership with power of decision. Resource allocation included the need to set aside time and administrative resources and also the need to adjust essential IT-systems. The work of anchoring to create engagement involved both patients and staff and was found to be a never-ending task calling for deep commitment. The hospital top management’s explicit decision to implement VBHC facilitated the implementation process, but the team leaders’ lack of explicit management mandate was experienced as obstructing the process. The development process contributed not only to single-loop learning but also to double-loop learning.

Originality/value

Learning experiences drawn from implementing VBHC have not been studied before, and thus the results of this study could be of importance to managers and administrators wanting to implement this concept in their respective organizations.

Details

Leadership in Health Services, vol. 31 no. 1
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 5 June 2017

Peter McGough, Susan Kline and Louise Simpson

As the US health system moves to value-based care and aligns payment with quality, the role of the primary care provider (PCP) is becoming ever more important. The purpose…

Abstract

Purpose

As the US health system moves to value-based care and aligns payment with quality, the role of the primary care provider (PCP) is becoming ever more important. The purpose of this paper is to outline a successful population health and care management strategy depending on accountable teams to standard workflow and agreed upon process and outcome measures in order to achieve the triple aim of improved health, patient experience, and value.

Design/methodology/approach

Two major areas of focus for primary care are ensuring that all patients receive appropriate evidence-based screening and prevention services and coordinating the care of patients with chronic conditions. The former initiative will promote the general health and well-being of patients, while the latter is a key strategy for achieving better outcomes and reducing costs for patients with chronic conditions.

Findings

To achieve these goals while managing a busy practice requires that the authors leverage the PCP by engaging clinical and non-clinical team members in the care of their patient population. It is essential that each team member’s role be clearly defined and ensures they are working at the top of their scope.

Originality/value

This initiative was successful because of the compelling objectives, the buy-in generated by using Lean methodology and engaging the team in the design process, use of multiple feedback mechanisms including stories, dashboards, and patient feedback, and the positive impact on providers, staff, and patients.

Details

International Journal of Health Governance, vol. 22 no. 2
Type: Research Article
ISSN: 2059-4631

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Article
Publication date: 18 January 2021

Agnė Gadeikienė, Asta Pundzienė and Aistė Dovalienė

The rise of telehealth is evident worldwide, especially now with the COVID-19 pandemic situation, and is providing extensive opportunities for health-care organisations to…

Abstract

Purpose

The rise of telehealth is evident worldwide, especially now with the COVID-19 pandemic situation, and is providing extensive opportunities for health-care organisations to create added value for different stakeholders. However, even in this extreme situation, the progress of telehealth is quite slow and insufficient. In this context, it is necessary to consider how the application of telehealth services allows co-creating additional value for different stakeholders. Consequently, the purpose of this paper is to explore telehealth services and the added value that they co-create for various stakeholders across publicly and privately oriented health-care ecosystems.

Design/methodology/approach

This paper adopted a qualitative research design based on an explorative and comparative approach to study the perceived added value that is co-created during telehealth encounters. The authors deployed a semi-structured interview research design. Interviews were carried out in two settings that have different health-care systems: Lithuania (publicly oriented health care) and the California Bay Area, USA, (privately oriented health care). The research covers telehealth services from the point of view of different stakeholders in the health-care ecosystem.

Findings

The paper emphasises that value-in-use is essential in the case of telehealth; however, value-in-exchange is relevant to describe the relationships between public and private insurers and health-care providers. The findings point out that despite the type of health-care system, telehealth added value-in-use was perceived quite similar in both research settings, and differences could be distinguished mainly at the sub-dimensional level. The added value-in-use for patients comprises economic, functional and emotional value; physicians potentially get functional added value-in-use. The authors also highlight that patients and physicians get relational functional and social value-in-use. The added value-in-use for health-care providers consists of economic (in both research settings) and functional value (in Lithuania). The research findings show that there is still an evident lack of health insurance companies ready to recognise telehealth as a valuable service and to reimburse similarly to in cases of in-person visits. Thus, the added value-in-exchange is hardly created and this impedes co-creation of the added value-in-use.

Originality/value

This paper contributes to the field mainly by transferring the business research applied concept of value co-creation into the social-purpose driven health-care industry. The findings are beneficial for the health-care management stream of the literature, which considers health care as a value-based industry. To the best of the authors’ knowledge, this is the first attempt to structure the perceived telehealth added value from the perspectives of different stakeholders and two different health-care ecosystems. This paper also gives a clearer understanding of the role of the value-in-exchange in such complex ecosystems as health care and gives reasons when it could be created in synergy with co-creation of the value-in-use. In this sense, the findings are beneficial from both marketing and innovation theoretical perspectives, as they give a special attention to value creation and co-creation phenomena analysis.

Details

International Journal of Organizational Analysis, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1934-8835

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Article
Publication date: 13 November 2018

Brian Leavy

This masterclass examines how two important new books propose to achieve cost innovation, a value creation strategy that can transform an over-priced industry.

Abstract

Purpose

This masterclass examines how two important new books propose to achieve cost innovation, a value creation strategy that can transform an over-priced industry.

Design/methodology/approach

In their book, marketing gurus Stephen Wunker and Jennifer Luo Law highlight the potential of cost innovation in helping to create new market demand and transform the competitive dynamics in any industry sector, and they offer guidance on how to develop such a strategy. In their study of transformation by value creation, Professors Vijay Govindarajan and Ravi Ramamurti highlight the potential for cost innovations in emerging markets to help transform health care delivery in the West.

Findings

The authors showcased in this masterclass demonstrate how the value-based principles highlighted by Porter and Christensen and Kim and Mauborge are key to transforming any industry to make it more reliable, accessible and affordable.

Practical implications

Cost innovation involves taking a fresh approach to the conventional way of delivering value in any given industry and looking for ways to reimagine it.

Originality/value

The notion of cost as a potential target for breakthrough innovation in its own right is still not widely recognized. As marketing consultants Wunker and Luo Law point out in Costovation: innovation and cost are still most often seen as “magnetic opposites,” the one in natural tension with the other. They set out to challenge this assumption and show how “innovation and cost-cutting” can become “a powerful duo, capable of reshaping markets and creating long-term competitive advantages.”

Details

Strategy & Leadership, vol. 46 no. 6
Type: Research Article
ISSN: 1087-8572

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