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VBC Episode 2: Challenges for Value Based Care

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The second episode of our series on value based healthcare is all about why delivering value based is hard. We will focus on just the two main challenges: technology and people.

Technological prerequisites

Value based care depends on healthcare providers getting paid for how well they made their patients, and not for how well they were able to sell them services that they don't need. In order to do that effectively, health systems need to be able to measure accurately (at least) 1/ how sick was the patient when he/she came in, and 2/ how well they were when they got out. At the moment this means trawling through patient records usually manually. Doing so for every patient would increase the cost of care unacceptably unless the process can automated. More on this, next week.

People's Conflicts of Interest

The second issue is that doctors have an inherent conflict of interest: Under the prevalent fee for service system, doctors' income depends only on how much they are willing to load their patients with tests and medications they don't need. Doctors don't have to be sinister to be unethical, as humans we all do this all the time. Doctors would need to overcome their own unconscious biases (even more so in the private health sector) in order to support a switch to VBC.

Dan Ariely TED Talk: Beware Conflicts of Interest

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