"Value-Based Healthcare: A Scam in Modern Medicine"

Completely agree, the vision of Value-Based Healthcare has been overshadowed by financial metrics and administrative performance indicators rather than genuine patient outcomes. In many cases, hospitals are incentivized to shorten length of stay even when patients require extended care, or penalized for readmissions driven by socioeconomic factors beyond clinical control. This approach reduces medicine to data management rather than healing. It’s time for healthcare leaders to confront this reality and rebuild a model that prioritizes individualized care, clinical integrity, and true patient-centered value, and NOT spreadsheet-driven efficiency. #VBHC #patient_centered #efficiency #outcomes

FICCI–EY-Parthenon Healthcare Report Summary 1. Patient Demand for Transparency 83% of patients seek objective, accessible healthcare information. 90% are willing to pay more for certified quality. Only one-third access reliable data; most rely on brand (60%) and word-of-mouth (79%). Patients favor managed care for chronic diseases but cite limited diagnostics (49%) and provider options (48%). 2. Clinician Perspectives 90% stress standardized clinical pathways. 65% support outcome measurement; 35% already proactive. Three-fourths want streamlined, patient-centric processes. Enablers: teamwork (64%) and digital tools like EHRs (49%). 3. Capacity Gains & Gaps Since 2000: beds nearly doubled, MBBS seats up 5x, cath labs 58x, linear accelerators 17x. Tech adoption gap shrunk from 10 to 2 years. Gaps: globally low bed density, small hospitals (25–30 beds vs 100+), fragmented payor base (top 5 cover ~40%), and stark geographic disparities. 4. Shift to Longitudinal Care Acute, episodic care unsustainable. By 2047, hospitalization may rise 2.5–3x, needing 20–30 lakh new beds, pushing spend to 6–7% of GDP. A longitudinal approach could reduce hospitalizations by 20–30% and cap spend near 5% of GDP. 5. Regulation & Accreditation <10% hospitals NABH-accredited; <2% labs NABL-certified. Smaller nursing homes need support for compliance. Advances: NABH programs, ICMR workflows, ABDM, QCI grading, PPP/VGF schemes, Ayushman Bharat payouts tied to quality, CGHS tiered rates. Barrier: weak adoption and collaboration mechanisms. 6. Digital Framework (VALUE) Vital infrastructure (HIS, EMRs). Advanced interoperability (ABHA). Leverage AI/GenAI. Unified care platforms. Evidence-based governance (dashboards, outcomes). 7. Path Forward – 7C Model Cohorting & segmentation, Clinical excellence, Cost consciousness, Care reimbursement, Care coordination, Consumer empowerment, Connected ecosystem. Bottom line: India has expanded rapidly and is efficient due to cost advantage, but faces fragmentation, low accreditation, and trust gaps. Patients and clinicians favor outcome-based, digital-first, transparent care. Adopting longitudinal models, stronger regulation, and the 7C framework can ensure sustainable and equitable healthcare

Healthcare Trends That Deserve More Attention: Insights from C-Suite Executives C-suite executives from hospitals, health systems, academic medical centers, and universities across the U.S. shared the underappreciated healthcare trends that deserve more attention: 🔹 Rising Healthcare Costs and Inflation Monitor inflation, rising labor costs, drug expenses, and provider consolidation to manage increasing healthcare costs. 🔹 Accessible and Affordable Care Invest in ambulatory care and expand outpatient services to provide cost-effective, patient-preferred care. 🔹 Balancing Fee-for-Service and Value-Based Care Balance fee-for-service and value-based care to leverage strengths of both models and empower employees. 🔹 Infrastructure for Digital Innovation Develop robust infrastructure to support digital initiatives like virtual care and AI integration for high-quality patient care. 🔹 Integrating Behavioral Health Integrate behavioral health services into primary care using innovative payment models to improve access and outcomes. 🔹 Addressing Access Fatigue Adapt healthcare systems to patients' cultural, financial, and emotional needs to combat access fatigue. 🔹 Team-Based Care and Mental Health Promote team-based care and integrate mental health into primary and specialty care for better patient outcomes. 🔹 Enhancing Clinician Experience Improve clinician experience with better EHR integration and workflow automation to reduce frustration and enhance patient care. 🔹 Embracing Workforce Dynamics Adapt to younger generations seeking flexibility and purpose-driven work to stay competitive. 🔹 Combating Workplace Violence Address workplace violence to prevent nursing burnout and workforce attrition, ensuring safe work environments. 🔹 Adapting to Demographic Shifts Implement tech-enabled, community-integrated care models to sustain healthcare delivery for an aging population. 🔹 Operational Integration and Digital Transformation Focus on operational integration and digital transformation to advance health equity. 🔹 Personalized Preventive Care and AI Utilize personalized preventive care and AI to improve patient outcomes and clinician workflows. 🔹 Strengthening Supply Chain and Revenue Cycle Enhance supply chain management and revenue cycle to support access and sustainability. 🔹 Addressing Social Determinants of Health Integrate behavioral health and address social determinants of health to improve overall health outcomes. https://lnkd.in/gaVTY2dk

𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗜𝗻𝘃𝗼𝗹𝘃𝗲𝗺𝗲𝗻𝘁 — 𝗩𝗶𝘃𝗮 𝗹𝗮 𝗿𝗲𝘃𝗼𝗹𝘂𝗰𝗶𝗼𝗻 𝗼𝗿 𝗠𝗼𝗱𝗲𝗿𝗮𝘁𝗲 𝗔𝘀𝗰𝗲𝗻𝘀𝗶𝗼𝗻? A recent reflection by Ellie Choi et al. (2025) brought me back to an earlier post I shared on the importance, and limits, of incorporating patient perspectives in healthcare decision-making. As the authors eloquently argue, over-reliance on patient perspectives may compromise key normative principles such as non-maleficence and justice. This places clinicians in an untenable position: navigating the delicate balance between subjective patient input and objective clinical reasoning. While medicine has always operated in this grey area, there’s growing concern that an unchecked push for greater patient involvement could disrupt centuries of progress grounded in rigorous clinical science and established innovation pathways. From an economic standpoint, patient involvement in healthcare decision-making has led to a proliferation of competing schools of thought with some advocating for individual willingness to pay (WTP) as the ultimate measure of patient-centred value. While intuitively appealing, this approach raises critical questions around feasibility and equity. Culyer et al. (2018) caution against an overdependence on consumer (patient) preferences in healthcare markets, highlighting several core concerns:  • Socio-Economic Gradient: Health is inextricably linked to wealth. Valuing interventions based on individual WTP risks deepening inequities by skewing resources toward those with greater financial means.  • Principal-Agent Discordance: Many clinical decisions are not made directly by patients, resulting in a disconnect between expressed and actual preferences.  • Irrational Behavior: Standard economic assumptions about rational decision-making often don’t hold in healthcare. Preferences may violate basic principles like transitivity or consistency.  • Public Good Nature of Healthcare: As a public good in many contexts, healthcare cannot exclude individuals based on ability to pay. Aggregating WTP to determine value is not only impractical but conceptually flawed. Patient voices must absolutely be heard, but their integration into healthcare evaluation and decision-making should enhance equity and clinical effectiveness, not entrench or deepen existing disparities at a societal level. This isn't a revolution. It's a measured march towards more inclusive, deliberative, and balanced healthcare decision-making. Link to Choi et al (2025): https://lnkd.in/gRQSPD9T Link to Culyer et al (2018):https://lnkd.in/gxUHRRP6

A Shift in Physician Ownership: Embracing New Models The landscape of healthcare is changing, with only 42.4% of physicians working in private practice as of 2024, down from 60.1% in 2012. The shift towards employed settings is evident, as hospital-employed physicians increased by 33% from 2013 to 2022. However, interest in physician ownership is resurging due to concerns over autonomy and burnout. A 2024 Bain & Company survey indicates that 81% of physicians in physician-led organizations feel satisfied with their decision-making roles, compared to just 50% in hospital settings. Innovative management services organizations (MSOs) and hybrid ownership models are helping to revitalize ownership, allowing independent practitioners to leverage hospital resources while retaining autonomy. Collaborations, like Sentara Health's partnership with local clinics, exemplify this trend. As the healthcare environment evolves, these new ownership models present a promising future for independent physicians. #Healthcare #PhysicianOwnership #Innovation #PhysicianSatisfaction #HealthcareTrends

🏥 𝐆𝐨𝐯𝐞𝐫𝐧𝐦𝐞𝐧𝐭 𝐋𝐚𝐮𝐧𝐜𝐡𝐞𝐬 ‘𝐎𝐧𝐥𝐢𝐧𝐞 𝐇𝐨𝐬𝐩𝐢𝐭𝐚𝐥’ 𝐭𝐨 𝐂𝐮𝐭 𝐍𝐇𝐒 𝐖𝐚𝐢𝐭𝐢𝐧𝐠 𝐓𝐢𝐦𝐞𝐬 Prime Minister Keir Starmer has unveiled a pioneering new initiative that will harness artificial intelligence to dramatically reduce NHS waiting lists and bring care closer to patients than ever before. The announcement has provoked a lively reaction from across the health sector. Some physicians and health-tech leaders welcomed it as a bold and necessary modernization. Dr Rachael Grimaldi, Co-founder and Chief Medical Officer at CardMedic, said the plan is transformative “if its design is fundamentally inclusive from day one”, but warned that it currently lacks a clear implementation blueprint. Others — including Alex Johnston of Solventum Health Information Systems — emphasized its potential to cut waiting times, reduce inequalities, and give patients greater choice and control. Still, critics flagged concerns over digital exclusion, governance, clinician sourcing, and clarity of operational structure. Set to launch in 2027, the “Online Hospital” programme aims to deliver more than 8.5 million appointments within its first three years. By integrating AI tools into the NHS App, patients will gain faster and easier access to essential healthcare services. Through the app, users will soon be able to: • Receive AI-guided clinical advice tailored to their condition • Obtain referrals for scans and diagnostic tests • Manage prescriptions and ongoing treatments • Book procedures at local hospitals or surgical hubs This initiative marks a new era for the NHS, where AI, data, and clinical expertise come together to enhance decision-making, increase capacity, and improve patient outcomes at scale.

MediTalk Connect The True Meaning of Value-Based Healthcare: Transforming Care Beyond Cost and Towards Compassion In today’s complex and ever-evolving medical landscape, value-based healthcare has become a term that dominates discussions among healthcare professionals, policymakers, and patients alike. Yet, for many, it remains misunderstood. Contrary to what some might think, value-based healthcare isn’t just about money—it’s about meaning, measurable outcomes, and human dignity. It’s a movement that challenges how we define success in medicine—not by how much we spend, but by how much we heal. The Shift from Volume to Value For decades, healthcare systems worldwide operated under a fee-for-service model, rewarding quantity over quality. The more tests, procedures, or hospital visits, the greater the financial return—regardless of patient outcomes. But this system led to burnout, inefficiency, and disillusionment among both patients and providers. Enter value-based healthcare (VBHC)—a transformative approach designed to prioritize outcomes over output. In this model, providers are rewarded for improving health, reducing the effects of chronic disease, and helping patients live better lives. It’s about treating the person, not just the problem. Putting People, Not Profits, at the Center The essence of value-based healthcare lies in its human-centered philosophy. It measures success not by hospital revenue but by how patients feel, recover, and thrive. It asks deeper questions: Are patients living longer, healthier lives? Are treatments reducing complications or readmissions? Are healthcare providers empowered to deliver compassionate, coordinated care? When the focus shifts to value, care becomes personal, outcomes become measurable, and trust becomes the foundation. It’s a win-win for patients, practitioners, and policymakers. Technology: The Bridge to Better Value In the age of digital transformation, data and technology are the driving forces behind value-based care. Electronic health records (EHRs), AI diagnostics, telemedicine, and predictive analytics are redefining how providers monitor outcomes, identify risks, and personalize treatments. But the technology itself isn’t the “value.” The real value lies in how it enhances the patient experience—faster diagnosis, more accurate treatments, and continuous care beyond hospital walls. #GratienMukeshimana #28COE #28coeecosystem #MediTalkConnect #HealthcareInnovations https://lnkd.in/dUCwvXNN

In case you missed it, Becker’s Hospital Review recently highlighted the Top 10 growth areas for healthcare leaders in a compelling article. One point that especially caught my attention is growth opportunity #6 which centers on Value-Based Care and Strategic Partnerships. It’s a timely reminder of where innovation and collaboration are driving real impact. Link to the article - https://lnkd.in/ejmu4yyU As health systems shift from fee-for-service to value-based care, the stakes have never been higher. Success depends on outcomes, efficiency, and prevention—but none of that is possible without accurate provider data. Every care coordination effort, every payer contract, every quality metric hinges on knowing who your providers are, where they practice, and how they’re credentialed. Inaccurate or outdated data leads to denied claims, delayed reimbursements, fractured care continuity, and compliance risk. At Madaket Health, we believe provider data accuracy isn’t just operational; it’s strategic. It’s the infrastructure that enables: • Risk-sharing with confidence: Clean data ensures attribution models are correct and reimbursement aligns with performance. • Seamless payer partnerships: Accurate enrollment data reduces friction and accelerates value-based contracting. • Population health precision: Knowing exactly who delivers care—and where—drives better targeting and outcomes. • Regulatory resilience: Accurate data supports compliance with CMS, NCQA, and other value-based frameworks. Hospital executives are investing in digital health, community partnerships, and retail expansion. But without a clean provider data foundation, those initiatives rest on shaky ground. Let’s connect to explore how Madaket Health can help you build the data infrastructure that powers your value-based future.

Innovation meets reality in healthcare At the latest Flying Health Breakfast, Pia Maier, Nicole Lachmann and Prof. Dr. Clarissa Kurscheid discussed one of the most pressing questions around “Market access and reimbursement for innovative medical devices”: Why do so many innovative medical technologies never make it into patient care especially in the outpatient sector? The discussion revealed a clear picture: Market access for innovation in Germany is far from innovation-friendly. Key barriers in the current system: 1. Evidence requirements beyond practical reality: - Randomized controlled trials (RCTs) are often difficult to conduct for medical devices. - Incremental innovations are excluded because the focus lies too heavily on “additional medical benefit” while efficiency gains hardly count. 2. Bureaucratic roadblocks: - Lengthy NUB and assessment procedures, rigid processes and inflexible structures make access particularly difficult in outpatient care. - Even improvements or updates to existing products are barely recognized in current regulations. 3. Innovation Fund without real impact: - By the time projects reach standard care, many products are already outdated and can only be reimbursed in their original form. 4. Cultural barriers: - In outpatient care, there is often a lack of openness toward innovation. In addition, patient and physician adherence remains a major challenge. Takeaway from the discussion: Germany needs a new logic for reimbursement moving away from rigid evidence requirements toward flexible, patient-centered evaluation mechanisms that truly enable innovation. What other barriers do you think need to be addressed?