High Value Practice Academic Alliance
~The Hippocratic Oath
As the cost of health care in the United States continues to rise, of utmost concern are reports that medical bills are creating substantial hardships for patients and that the cost of health care is now the biggest financial concern facing American families. Health care debt is a leading driver of personal bankruptcy and home foreclosure. Both insured and uninsured patients are burdened by medical bills. Confounding these issues is evidence that patients avoid necessary care (prescription refills, doctors appointments) because of cost. In response to these challenges, providers across the country are reflecting on their practice to identify opportunities and implement initiatives that improve patient care quality and safety while reducing costs.
To efficiently and effectively advance this work on a national scale, the High Value Practice Academic Alliance was established in 2016, and faculty leaders from >90 partner institutions in the US and beyond, representing 30 different medical specialties & subspecialties, have joined the organization. Venues to deliver change include multicenter publications, a national conference in its 3rd year, professional development programs for house staff and junior faculty and ongoing collaboration.
Architecture of High Value Health Care
A strategic plan is essential to ensure the quality, safety, and effectiveness of a new high value model for health care delivery. “Value” has been defined in various ways, with costs as the universal denominator and more recently cost-effectiveness as the numerator. Early and efficient diagnosis and management, patient safety, patient experience and disease prevention are key elements of the cost-effectiveness, underscoring the importance of quality-driven care refinement and systematic analyses to measure outcomes. To effectively refine medicine, performance improvement efforts must be implemented across 5 pillars:
- Diagnostic and therapeutic efficiency
- Quality-driven care pathways
- Care transitions including hospital discharge
- Optimizing patient care setting
- Preventive medicine and healthy lifestyle
While many different organizations are contributing to these efforts, the transition will only be successful if medical providers become accountable for improving the value of the care they deliver and join the charge to advance value-based quality-improvement. In the words of Richard Duszak, MD, Director of Health Policy and Practice in the Emory Department of Radiology, “Real innovation will only come from the ground up – from doctors and nurses and patients, and everyone else in the trenches.”