To see progress on value, we must look locally

In the policy brief, A generation of healthcare in the United States: Has value improved in the last 25 years?, the authors argue that because our country’s health care spending has grown faster than our rate of improved health outcomes, health care value has not grown in that time. 

While I agree that value growth may not be obvious on a national scale, we should not merely attempt to measure this concept from a bird’s-eye view. Instead, the true movement on value can be found at the local level, where it’s progressing every day in our nation’s hospitals and health systems.

In fact, the hospital percentage of total health care expenses has declined since 1980, according to the Peterson Kaiser Health System Tracker. And, hospitals have made substantial efforts to improve quality outcomes, resulting in meaningful progress in providing high-value, affordable and person-centered care.    

For example, the University of Illinois Hospital & Health Sciences System in Chicago recently moved some chronically homeless patients into fully independent and permanent living situations. As a result, those patients were 35 percent less likely to go to the emergency department, and their health care costs shrunk by 42 percent.

Northern Montana Hospital improved the rate of amputations among local diabetic seniors after boosting their emotional and social support systems and incentivizing them to be more physically active through a health outreach program.  

Clinch Valley Medical Center in Richlands, Va., reduced avoidable readmissions for its local population by 4 percent and even lowered one patient’s monthly prescription drug costs from $1,700 to $200. 

Each of these programs saved thousands of dollars per patient and made for happier and healthier communities. Many more examples like these can be found at hospitals and health systems across the country.

If that’s not progress on value, I don’t know what is.

While we don’t have a formal definition of health care value at the AHA, we embrace the field’s widespread notion of value as outcomes and patient experience divided by cost. I can tell you that, despite increased input prices, regulatory burden and other challenges, hospitals and health systems are improving the field’s value proposition by improving outcomes while reducing cost simultaneously.  

As part of AHA’s The Value Initiative, we’re sharing examples of members in action so others can draw lessons and scale similar efforts. Over time, we will be able to more accurately track movement on value on a national scale.

In the meantime, hospitals continue to prove that, when they redesign their delivery systems, improve quality and outcomes, manage risk and offer new payment models, and implement operational solutions that will reduce costs, they contribute enormous value to their patients and communities.