J Korean Med Assoc.  2017 Oct;60(10):826-840. 10.5124/jkma.2017.60.10.826.

Value-based healthcare: prerequisites and suggestions for full-fledged implementation in the Republic of Korea

• Hurh J
• Ko YH
• Lee SS

• KMID: 2393528
• DOI: http://doi.org/10.5124/jkma.2017.60.10.826

Abstract

Healthcare systems around the world share the common goals of improving clinical outcomes, optimizing cost reductions and efficiencies, and expanding access to care in a patient-centric manner, yet they are stymied by 2 critical challenges: wide variations in patients' clinical outcomes and soaring costs. In response to these challenges, many healthcare systems throughout the world are pivoting towards value-based healthcare (VBHC), to ultimately 1) move from volume-based to value-based care, 2) promote patient-centric care, and 3) reverse rising costs. While the United States and European nations are piloting alternative payment models, South Korea has a similar set of objectives to adopt value or performance-based payment systems. Two exemplary programs helping to move Korea towards a VBHC model are currently under way: the Support Fund Program for Care Quality Assessment and the Healthcare Benefit Appropriateness Assessment Program. However, in order to permanently establish a full-fledged VBHC system in Korea, the following prerequisites must be met: 1) normalization of provider payment rates, 2) development and dissemination of critical pathways, 3) implementation of pilot projects in the medical device sector that contain risk-share payment schemes, 4) implementation of registries to aid data-driven coverage decisions, and 5) implementation of bundled payment pilot programs for the medical conditions for which proven critical pathways already exist. Ultimately, the medical device industry is in a unique position to enhance ongoing endeavors by Korean health authorities and providers to achieve quality patient care and cost savings, all in the service of the transition to VBHC.

Keyword

Value-based healthcare; Clinical outcomes; Cost control; Delivery of health care; Republic of Korea

MeSH Terms

Cost Control
Cost Savings
Critical Pathways
Delivery of Health Care*
Financial Management
Korea
Patient Care
Pilot Projects
Registries
Republic of Korea*
United States

Figure

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  Figure 1. Frameworks transformation for a value-based health care system establishment. ICT, information and communication technology. Reproduced from Kang HJ. Health Welf Policy Forum 2016;231:15-30, according to the Korea Open Government License [22].

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