Value-Based Health Care in the Midst of the Pandemic

System-wide change is possible; the pandemic response demonstrates this Seeing how some countries have created the opportunity to transform their healthcare systems as they respond to this pandemic from a value perspective sparks much optimism on system- wide change. Countries are learning from others’ experiences and are seeing the benefits of quickly applying value- based approaches. Over the past decade, there have been many attempts to enhance the sustainability of health systems globally through VBHC, such as bundled payments, alternative payment models and others. The COVID-19 pandemic has highlighted the need to expedite these reforms and analyze what has been effective and how to accelerate the change. It is important to resume and accelerate VBHC work that started before the pandemic on payment reform, and not allow the pandemic to halt these efforts. These payment models have shown to be more resilient in the face of the outcomes of the COVID-19 pandemic, and protect physicians, healthcare workers and populations against financial hardships, and need to continue throughout and beyond the pandemic for the sustainability of health care and delivery. They would also serve as an opportunity during the recovery phase of the pandemic and given the budget constrains; approaches such as capitation and incentivization for outcomes would serve as an additional opportunity to implement value-based approaches. Gains in technological enablement must be sustained, deliberately extended and not reversed The widespread use and prompt implementation of telehealth and telemedicine services is one other positive emerging from this year. Although telehealth services benefits are clear - in terms of convenience, cost and protection against exposure to the virus - it is important to address privacy concerns and ensure benefits are seen by patients, providers and the healthcare system. Other technologies implemented during the pandemic have shown to be effective tools to facilitate the delivery of healthcare to both COVID-19 and non-COVID-19 patients, as well as

policymakers to intensify the recovery efforts now and provide the necessary resources to support people’s needs post-pandemic. The need to focus on mental health as we recover from this pandemic The effects of the pandemic have exacerbated mental health issues such as depression and anxiety, and it is crucial to take measures to help the mental health and wellbeing of persons and communities affected by the pandemic. The pandemic has also affected the accessibility to mental health services, but there have been many positive approaches that have helped in tracking the mental health of individuals and communities such as telehealth and applications that have made it easier for individuals to access high quality services online. Restarting health system activity requires more than managing down existing waiting lists As most hospitals postponed non-emergency procedures at the start of the pandemic, many countries find themselves with large backlogs of cases to be attended to. Hospitals will find it more challenging now as waiting lists continue to lengthen, shortages in workforce experienced, infection control protocols remain strictly enforced, operational capacity constrained, and fluctuations in the prevalence of COVID-19 cases that remain. If the backlog issue isnot addressednow, healthcaresystems might need to deal with the consequences of potentially higher morbidity and mortality due to the delayed procedures. Solutions include many value-based healthcare approaches to tackle this issue, including the use of artificial intelligence and data analytics to manage capacity and prioritize cases in real time, other solutions that would focus on increasing the efficiency and use of available resources may include increasing operating rooms and compensating staff for working overtime. Although it may take years to work through the excess surgeries, these value- based approaches may be an opportunity for providers to strengthen clinical operations and transform care delivery to improve patient experiences and outcomes in the future.

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