The healthcare system is a crucial and yet fragile one, in any scenario we look at it within. The reality we face is an overburdened healthcare system, taking an even greater toll since the COVID-19 pandemic. The pressure gaps and issues we face are now clearer than ever before to see, and the time to act is now. At the same time, as we look at this healthcare crisis, we recognise it is not for Botswana alone to experience, not to solve – this is a global phenomenon we are seeing in many markets. But how are we solving for it? And is the onus on healthcare providers alone?
The concept of value-based healthcare is fast becoming a go-to, and with good reason. However, it is not new. Indeed, it has been around for some time and has been a primary focus for work delivered by, for example, the World Economic Forum (WEF) and even the World Health Organisation (WHO). Value-based care ties the amount health care providers earn for their services to the results they deliver for their patients and aims at promoting quality of care over the quantity of services. There is less focus on frequency of healthcare interventions or doctor visits, and rather, priority is placed on the quality of care and the progress experienced for the customer or patient. Ultimately, this approach improves overall health and wellbeing of the population and has proven effective in such markets as Kenya, the US, the UK, and in the public sector of Botswana.
According to the World Economic Forum, “The widely accepted definition of value in healthcare is the health outcomes that matter to patients relative to the resources or costs required to deliver those outcomes. Value-based healthcare is an approach that aligns industry stakeholders (payers, providers, pharma/MedTech and policymakers) around a shared objective of improving patient health outcomes, providing autonomy and accountability to providers to pursue the best way to deliver healthcare for the money spent. The transition from volume-based to value-based healthcare will inevitably lead to more healthy societies while optimising resources
As Bomaid, we have adopted the Value-Based Care approach locally, it is in line with one of our key strategic pillars of improving holistic wellness which is patient-centred and anchored in Primary Health Care. It helps better manage healthcare costs which are ultimately borne by customers through annual subscription increases and other out-of-pocket expenses, recognising that medical providers alone are not the only agents of change in this space – medical aid providers are crucial to supporting the wider ecosystem growth and betterment.
Patient-centred care or personalised care, on the other hand, focuses on the individual's particular healthcare needs. The goal of patient-centred healthcare is to empower patients to become active participants in the management of their care. Core to the principles of patient-centred care is personalisation and individual accountability towards one's own health. Value-based healthcare focuses on maximising patient healthcare outcomes and harnessing resources to better deliver on this while reducing inequity in health outcomes and promoting high-impact interventions. This is, ultimately, what Bomaid strives to do in working towards delivering, first things first, health, happiness and holistic well-being.
So how do we deliver value-based healthcare sustainably and meaningfully?
It begins with a mindset, yes. But this is swiftly followed by many tangible factors too: the right systems; the right infrastructure; the right resources; and The right regulatory environment. It means putting holistic patient well-being and health first, as well as removing inefficiencies that would otherwise result in cost burdens on patients, as well as unimproved health outcomes – always being ill, never seeing real recovery.
The WEF further notes, “This high-cost burden can, in part, be the consequence of inefficiencies in the healthcare system, such as fragmented and uncoordinated care delivery, poor data governance, workforce shortages and underinvestment in preventive care. The OECD estimates that up to 20% of healthcare spending across its member countries is unnecessary or ineffective. Accordingly, spending more doesn’t always lead to improved patient outcomes. So, addressing these inefficiencies would help reduce costs and make healthcare more equitable and accessible.”
As we strive for healthier, happier people across the nation, how do we help leverage value-based care to ensure better healthcare outcomes are the only acceptable result, and that we help ensure quality and relevant, appropriate healthcare is equitable, accessible, and inclusive?
It is not for us to suggest our approach is by any means a silver bullet, but it is one worth exploring because the global results speak for themselves. Now, how do we collectively mobilise in recognition of the fact that some discomfort for the industry now means progress for our patients and customers? This, after all, remains our priority.
Aligned to the Botswana Government through the Ministry of Health's strategic agenda for Primary Health Care Revitalisation, the time is now to refocus the Private Health Care system towards value-based care to create sustainability and resilience in our health sector as a country.
By Dr. Malebogo Kebabonye, Bomaid Chief Clinical Services Officer