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Discovering Value-Based Health Care
Interactive Learning Modules from Dell Medical School


MISSION: EMPOWERING YOU TO DELIVER HIGH-VALUE CARE TO PATIENTS


We find ourselves in a turbulent but exciting time in health care. As a society, our capabilities to diagnose and treat disease are accelerating at a remarkable pace, yet unless we understand how to deliver health care in ways that meaningfully and consistently improve patient outcomes, we will fail to achieve our true goals. We must learn how to consider the intricate needs of our patients – their health circumstances, priorities, context, time and monetary stress – and to integrate the powerful capabilities of our health care system to provide the best possible care for each patient in front of us.

This transformation will occur on multiple levels. Leaders will transform the culture, strategy and goals of their organizations to high-value care delivery. Individuals, particularly early in their careers, often have less influence on the transformation of systems, but each of us can still make a difference. This course aims at that day-to-day difference you can make to improve the value of health care delivered in our current systems.

We must understand and embrace the concepts of value-based health care: maximizing outcomes that matter to patients per total costs of care. Our mission in this course is to help you as a professional – a medical, nursing, pharmacy or social work student; a resident physician or clinical fellow; a frontline physician or nurse; a respiratory, occupational, or physical therapist - not only learn what high-value health care is, but to engage you in the mission to ensure we can deliver on this promise to our patients. We seek through these modules to provide you with tools and to empower you to be a model for health care change and a leader in the effort to bring value to the forefront of our field.




Collection 1

Introduction to Value-Based Health Care

What is value in health care? This collection contains three modules, which introduce the concept of value in health care - outcomes that matter to patients / total costs of care - and describes what it means for both patients and clinicians. Module 2 explores different types of measures and discusses the importance of measuring outcomes that matter to patients (the numerator of the value equation). Module 3 confronts the confusing world of costs in health care (the denominator of the value equation), defining different cost terms and payment models, and exploring cost accounting and insurance coverage structure.

MODULE 1

THERE'S A BETTER WAY

Our medical system is vast, complex, and teeming with wide variations in outcomes, disparities in care and results, virtual miracles and tragic harms, overuse, underuse and inappropriate use of services, inefficiencies and waste. These complex issues impact the care we provide and the outcomes of patients’ care, and they can seem an overwhelming problem too difficult to fully comprehend, let alone change. This module defines the goals of value-based health care—working with patients and families to achieve better health outcomes, efficiently. The most powerful way to improve value is to improve health outcomes in ways that reduce costs. Beyond the obvious examples in prevention, we present care improvements that either improve health outcomes in ways that reduce costs or simultaneously improve both outcomes and costs. One of the most straightforward ways to simultaneously improve outcomes and decrease costs is to cut out waste. Thus, we also identify the most common areas of inefficiency and wasteful practices in health care. These understandings can enable dramatic and ongoing improvement in health outcomes for patients and in the efficiency with which they are achieved.

MODULE 2

MEASURING WHAT MATTERS

How do we measure our success in health care? How do we define it, and where do we begin? These questions have a very clear answer: our success is inextricably tied to and based on our patients’ outcomes. In this module, you will explore how to measure outcomes that matter to patients. We will discuss patient goals, priorities, desires, and experiences. Meaningful health outcomes are true measures of success, and learning to account for and base patient care around the whole patient–not just his or her symptoms—enables delivery of high value health care.

MODULE 3

UNDERSTANDING COSTS IN HEALTH CARE

The costs of health care are way too high given the outcomes now achieved. Overuse, underuse and inappropriate use of care cumulate to stunning amounts of wasteful spending that drive costs up. Costs are a major problem with our health care system today, not only at the individual patient level, but at the level of organizations as well. This course focuses on how professionals can influence and change spending. Costs, how they cumulate and how they relate to prices that patients pay, are complex and often opaque. In this module, you will learn how costs occur and how this differs from how costs are assessed and tallied. You will see three methods of cost assessment and consider different types of physician reimbursement. You will also consider which methods provide the most transparency. Through gaining an understanding of and ability to discuss health care costs, you will be armed to provide clarity to your patients about the expense they may face from unnecessary services.

Collection 2

Value-Based Health Care Delivery

Collection two examines what value-based health care delivery can look like in practice. The collection contains two modules that cover the importance of working with teams to coordinate care around the needs of patients, including the description of two example delivery structures: Integrated Practice Units (IPUs) and Patient Centered Medical Homes (PCMHs). Module 5 brings the concepts from modules 1-4 all together and covers the 6 guiding principles of value-based health care delivery.

MODULE 4

Coordinating Care for Patients

The current model of health care delivery in the United States is often fragmented and uncoordinated, leaving patients to manage their care coordination on their own. This module defines and explores two models for value-based care delivery that aim for better team-based care coordinated around the needs of patients: Integrated Practice Units (IPUs) and Patient Centered Medical Homes (PCMHs). The module highlights a real example of an IPU at Dell Medical School that focuses on women’s health and explores what it takes to build an IPU.

MODULE 5

Bringing It All Together: Value Based Health Care Delivery

What is value-based health care delivery and what do we need to do to make it a reality? What do we need to keep in mind as we move from a volume-based system to a value based system? This module brings together concepts covered throughout modules 1-4 and summarizes the key components of value-based health care delivery. Each component includes concrete examples to show how this work is already being implemented in practice. Test your understanding of modules 1-5 by completing an interactive quiz activity at the end of this module.

Collection 3

Improving Value at the Bedside

How can clinicians integrate high-value care into their day-to-day work? This collection contains two modules and describes ways clinicians can enhance affordability for patients and communicate about costs and value. Module 6 primarily describes high-value prescribing and decreasing out-of-pocket costs for patients. Module 7 addresses the communication techniques that enable the delivery of high-value care.

Expected launch date: June 2018

Collection 4

Improving Value in Systems

This final collection of three modules addresses one of the more challenging aspects of value-based health care – how do we create programs that will improve value in the complex health care systems in which we work and receive care? This collection covers how culture influences health care value and introduces strategies to catalyze local culture change, along with proven improvement methods. We also review value-based payment models and strategies for controlling cost as components that can support the delivery of value-based health care.

Expected launch date: September 2018

The Dell Medical School Value-Based Health Care (VBHC) modules are supported by the generous grant support of the Episcopal Health Foundation. We have worked to develop a rich, interactive instructional experience that brings the expertise and research Dell Medical School has invested into the provision of VBHC together with an innovative, high-impact pedagogical approach.



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Congratulations!

Congratulations! You have completed all modules of Collection 1: Introduction to Value-Based Health Care. If you wish to receive a certificate of completion and/or AMA CME credits you must complete our evaluation survey through the University of Texas Dell Medical School as described here. If you wish to receive AAPA CME credits, you must return to the AAPA Learning Central to complete the evaluation survey.
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Congratulations!

Congratulations! You have completed both modules of Collection 2: Value-Based Health Care Delivery. If you wish to receive a certificate of completion and/or AMA CME credits, you must complete our evaluation survey through the University of Texas Dell Medical School as described here.
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