"Nathan Tierney’s powerful storytelling is rarely seen in today’s health care business environment. We must redesign the health care delivery system---a team sport in service of patients, hold it accountable with measurement to improve outcomes, and quantify the resource costs over the full cycle of care. Value-based health care is a framework through which these goals are achieved, and Tierney provides a detailed playbook to get your organization there. Outlined in incredible detail and clarity, he presents core concepts and dives into the key metrics needed to build, maintain, and scale a successful value-based health care organization. Nathan shares a realistic vision of what any CEO should expect when developing their own Value Management Office. Nothing is more important to me than improving the lives of those I love. My personal mission is to create systemic change with an impact on the global stage. This playbook needs to be on the desk of every executive, clinician, and patient today."
-Mahek Shah, MD, Senior Researcher and Senior Project Leader, Harvard Business School
Our current healthcare system’s broken. The Organization for Economic Co-Operation and Development (OECD) predicts health care costs could increase from 6% to 14% of GDP by 2060. The cause of this increase is due to (1) a global aging population, (2) growing affluence, (3) rise in chronic diseases, and (4) better-informed patients; all of which raises the demand for healthcare.
In 2006, Michael Porter and Elizabeth Teisberg authored the book ‘Redefining Health Care: Creating Value-Based Competition on Results.’ In it, they present their analysis of the root causes plaguing the health care industry and make the case for why providers, suppliers, consumers, and employers should move towards a patient-centric approach that optimizes value for patients. According to Porter, "value for patients should be the overarching principle for our broken system." Since 2006, Professor Porter, accompanied by his esteemed Harvard colleague, Profesor Robert Kaplan, have worked tirelessly to promote this new approach and pilot it with leading healthcare delivery organizations like Cleveland Clinic, Mayo Clinic, MD Anderson, and U.S. Department of Veteran Affairs. Given the current state of global healthcare, there is urgency to achieve widespread adoption of this new approach. The intent of this book is to equip all healthcare delivery organizations with a guide for putting the value-based concept into practice.
This book defines the practice of value-based health care as Value Management. The book explores Profesor Porter’s Value Equation (Value = Outcomes/ Cost), which is central to Value Management, and provides a step-by-step process for how to calculate the components of this equation. On the outcomes side, the book presents the Value Realization Framework, which translates organizational mission and strategy into a comprehensive set of performance measures and contextualizes the measures for healthcare delivery. The Value Realization Framework is based on Professor Kaplan's ground-breaking Balanced Scorecard approach, but specific to healthcare organizations. On the costs side, the book details the Harvard endorsed time-driven activity based costing (TDABC) methodology, which has proven to be a modern catalyst for defining HDO costs. Finally, this book covers the need and a plan to establish a Value Management Office to lead the delivery transformation and govern operations.
This book is designed in a format where any organization can read it and acquire the fundamentals and methodologies of Value Management. It is intended for healthcare delivery organizations in need of learning the specifics of achieving the implementation of value-based healthcare.
Table of Contents
Introduction: Putting Healthcare Value into Perspective; Chapter 1: Executive Summary; Problems facing healthcare delivery organizations; Recommendation for healthcare delivery organizations; Chapter 2: Healthcare Landscape; Global trends; Value-based trends; Summary of key points to remember; Chapter 3: How to Measure Value; Value Myths; A Healthcare Value-based balanced scorecard; Summary of key points to remember; Chapter 4: Value Management Office; The concept; Mission and vision; Role of the value management office; Governance and staffing of the value management office; Benefits of the vale management office deliverables; Management dashboards; Performance scorecards; Summary of key points to remember; Chapter 5: Value Realization Framework; Need for a framework;Value equation for healthcare; Application of the value realization framework and value equation; Summary of key points to remember; Chapter 6: Steps in the Value Realization Framework; Process overview; Step 1 – critical success factors; Step 2 – key results indicators; Step 3 – key performance indicators; Step 4 – value management; Summary of key points to remember; Chapter 7: Outcomes Metrics; Clinical outcomes; Financial outcomes; Patient satisfaction; Process improvement; Clinical satisfaction; Learning and growth; Summary of key points to remember; Chapter 8: Common Operating Picture; Getting insight from data; How does the common operating picture (COP) works?; Business analytics in healthcare; Summary of key points to remember; Chapter 9: Program Core Metrics; Program value management; Schedule reporting metrics; Cost reporting metrics; Resources key performance indicator; Scope key performance indicator; Quality key performance indicator; Risks key performance indicator; Summary of key points to remember; Chapter 10: Technical Metrics; Technical value management; Technology process index; ISO standards for software quality; Summary of key points to remember; Chapter 11: Other Index Metrics; Other metrics; Product portfolio index; New products index; Feature function index; Time-to-market index; Research and development success index; Summary of key points to remember; Chapter 12: Change Management; Transformation process overview; Step 1: create urgency; Step 2: building guiding coalition; Step 3: form strategic vision and initiatives; Step 4: communicate the vision; Step 5: remove obstacles; Step 6: create short term wins; Step 7: build on change; Step 8: anchor the change in corporate culture; Working groups; Summary of key points to remember; Appendix 1: Acronym list; Appendix 2: SMART Criteria; Appendix 3: Value Management Meeting Template; Appendix 4: References
Tierney, Nathan William
"Value. Value based care. Value optimization. Policy makers and providers alike are pressing on all fronts to drive healthcare to a better place based on "value". The risk is that value becomes a hollow, overused term with little or no quantifiable meaning. Nathan Tierney has compiled an excellent resource to help us avoid such a fate. Building upon the concept of a Value Management Office, Mr. Tierney provides us with a blueprint on how and why to create such an office, how to quantify value, and how to achieve a shared understanding and vision of what success looks like. This detailed roadmap is a must read for all in healthcare as a guide to understanding how to build value into our health delivery systems and to deliver measurable value-oriented outcomes."
-H. Stephen Lieber, President & CEO HIMSS
"Value-based health care is one of the most important concepts in health reform to emerge in the past 100 years of modern medicine. The concept, developed by Harvard Business School Professor Michael Porter, asks that the industry reshapes how it is organized and what it measures to improve outcomes and control costs. It is a concept that is embraced by patients, clinicians, administrators, and payers. While sometimes thought to be strictly conceptual, Nathan Tierney has assembled a book that takes health care organizations through a step by step process of how to create and run a value management office. He covers not only the basics of the value-based healthcare framework but addresses key issues like change and project management. This well written and concise guide will be essential for any organization embarking on a value-based health care journey."
-Dr. Thomas Feeley, MD Anderson and Senior Fellow Harvard Business School
" As healthcare organizations transition from traditional fee-for-service to value-based models of reimbursement, they’re re-engineering the way they do business.