From Theory to Reality: How Is Value-Based Healthcare Currently Being Implemented. A Realist Review of the Literature

Diogo de Oliveira Reis

Key information

Authors:

Diogo de Oliveira Reis (Diogo de Oliveira Reis)

Supervisors:

Carl Savage; Mónica Duarte Correia de Oliveira (Mónica Duarte Correia de Oliveira)

Published in

11 de julho de 2024

Abstract

Value-Based Healthcare (VBHC) is a management model introduced by Michael Porter, aimed at improving healthcare outcomes while controlling costs. The complexity of this management model and healthcare systems, in general, makes it key to understand how VBHC strives in some contexts but does not yield promising results in others. The literature around the topic emphasises that there is no "one size fits all" approach to VBHC implementation, underscoring the importance of tailored strategies to address specific healthcare settings. To better understand how VBHC initiatives, when adopted by healthcare organizations, produce intended or unintended outcomes, how the context behind those interventions influences their outcomes and how the interventions evolve and adapt to such contexts, a realist review of the literature was conducted, following a five-step methodology. The findings reveal that VBHC's success is highly context-dependent, and influenced by organizational structures, patient engagement, and specific healthcare settings. The study highlights that there is no universal approach to implementing VBHC, emphasizing the need for tailored strategies to address unique contextual factors. It also sheds light on new interventions and recommendations for implementing VBHC. This realist review offers a solid foundation for effective and tailored VBHC implementations, providing valuable insights for healthcare organizations and policymakers to assist in the decision-making and implementation processes, emphasizing the need for contextually relevant and adaptable strategies for VBHC.