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VBHC: 1. From Volume to Value

1. From Volume to Value

For many years, healthcare systems have focused on rewarding procedures and the number of treatments delivered to patients [1]. We all accepted without a doubt that more medical interventions meant improved health quality. But more is not always better.

Did you know that around 30% of resources spent on healthcare could be saved? [2] [3] The reasons for this waste of resources are many, but most importantly, it is because of unnecessary treatments [4].

Take as an example the National Health Services in Wales. They found that almost 20% of cataract surgeries do not improve the patient’s visual disability. We can find similar stories in France [5]… the Netherlands [6]… the USA [7]… Canada [8]

If such surgical procedures do not have a positive impact in daily life [9], what is the value to the patient?

More treatments means higher costs. Spending in healthcare has noted a significant growth rate over the past years [10]

… but increased costs are not correlated to better patient outcomes [1][3][11][12]… or health-adjusted life expectancy [13].

The global population is aging and the incidence of chronic disease and co-morbidities is increasing. Global healthcare spending is estimated to continue growing exponentially [14][15], putting more pressure on healthcare services.

It is not anymore a matter of applying quick fixes to reduce costs. We need to adopt a more efficient and sustainable healthcare system that delivers real value for patients.

Many organizations worldwide started implementing a results-based management approach. They do not measure their performance according to what they do, but according to what they achieve. Such organizations manage to perform less activities but only the necessary ones, well thought and integrated, and they obtain excellent quality outcomes with less costs.

Why not applying the same concept to the Healthcare system and shifting the focus from volume to value? [1] Why not putting the patients at the centre and targeting what brings the biggest value in their daily life, providing a high-quality healthcare while containing costs? [9]

It is a simple and beautiful concept, but implementing it requires changing the culture in the Healthcare system. The change has already started: over a hundred institutions in Europe have already embarked on a new healthcare approach that focuses on bringing value to the patients.

Join us on this journey towards a value-based healthcare system!

[1] Deloitte. 2016 Global health care outlook Battling costs while improving care. London: Deloitte; 2016.

[2] World Health Organization.The World Health Report 2010: Health Systems Financing: the Path to Universal Coverage: World Health Organization; 2010.

[3] OECD. Tackling Wasteful Spending on Health Paris [Internet]. OECD Publishing; 2017. [cited 20 March 2020] Available from:

[4] Bodenheimer T, Fernandez A. High and Rising Health Care Costs. Part 4: Can Costs Be Controlled While Preserving Quality? Annals of Internal Medicine. 2005;143(1):26-31.

[5] Blyth C., et al. Using outcome data and costs to demonstrate 'Value' in our Cataract Service: reducing variation & using outcomes to support direct care and triage. Poster presented during the ICHOM conference 2019 Rotterdam

[6] Jean-Marie V. Améliorer la pertinence des soins : un enjeu majeur pour notre système de santé. Sénat; 2017.

[7] Visser S, Westendorp R, Cools K, Kremer J, Klink A. Kwaliteit als medicijn Aanpak voor betere zorg en lagere kosten. Booz &; 2012.

[8] Axene DV, Doyle RL, van der Burch D. Analysis of medically unnecessary inpatient services: Milliman & Robertson; 1997.

[9] Naylor CD. What is appropriate care?. N Engl J Med. 1998;338(26):1918‐1920. doi:10.1056/NEJM199806253382612

[10] OECD. Health at a Glance 2019 [Internet]. Paris: OECD Publishing; 2019. [cited 15 Apr 2020] Available from:

[11] Ke Xu AS, Kutzin J, Callum Brindley, Vande Maele N, Toure H, et al. Public Spending on Health: A closer look at global trends [Internet]. Switzerland: World Health Organization; 2018. [cited 2020 Mar 12]. Available from:

[12] Morris M. 2019 Global health care outlook. Shaping the future. Deloitte. 2019.

[13] World Economic Forum. Value in Healthcare: Accelerating the Pace of Healthcare System Transformation. Geneva, Switzerland: World Economic Forum; 2018.

[14] Global Healthcare Expenditure Database [Internet]. World Health Organization. 2014 [cited 25.April.2020]. Available from:

[15] Mendelson DN, Schwartz WB. The effects of aging and population growth on health care costs. Health Affairs. 1993;12(1):119-25.

Please find all references here.