If you walk into a medical practice right now and use the word
“value” in a sentence, it’s almost saying a dirty word. Physicians
think you’re talking about quality metrics, equating to value-based
reimbursements. The process the regulatory body has used to engineer
the shift from a volume-based reimbursed methodology to a value-based
methodology has essentially tainted the word “value” in their
estimation. It’s a false premise of value. If you ask a physician if
many of the methods used to capture quality metrics actually reflect
quality within their practice, they would tell you, “no, it usually
means more clicks in the EHR.”
Unfortunately, it makes having a conversation about the real value
found within the medical practice a very difficult discussion. You must
first reframe the definition and its resulting connotation. Everything
that is associated with shifting to a value-based model has so heavily
burdened the medical practice, that it’s left a bad taste in everyone’s
So, to be clear, I’m not talking about THAT type of value. The
premise of value is not exclusively associated with new reimbursement
methodology. At every medical practice that I advise, my challenge is
to educate the physician and administrative leadership about what value
management really is.
Value management is dedicated
to motivating people, developing skills, and promoting synergy and
innovation, with the aim of maximizing the overall performance of an
organization. Value is derived when satisfaction outweighs the
cost. It’s about the relationship between meeting a need and meeting
expectations while balancing the impact of the cost required to do so.
Value management is a combination of planning
tools and methods to strike that optimum balance of project benefits in
relation to project costs and risks. I came to this philosophy
as I was completing my Master’s thesis; our team investigated “value”
at large corporations. These organizations have entire value
managementdepartments devoted to ensuring, overall, the company teams
collaborate, no division is a silo and value remains a focus across the
As I reflected on this construct, my aha moment was that rarely has
anyone ever talked about how to define value across the medical practice
environment with this specific value management focus. For example;
there are specific aspects of solutions and applications that divide the
front and back office. Some EHRs provide a solution or add-on module
for a single problem or issue but are not designed to integrate and
enhance the entire practice causing redundant workflows, increased
errors, and additional staff work and frustration.
So, I asked myself: What is the value management opportunity in health care, and specifically, within the medical practice?
If we start thinking about it, taking the cliché out of value is
really about aligning work with mission and vision. Ask yourselves, who
first needs to feel they have received value for their interaction with
your practice? If patients don’t receive what they perceive as
a valuable care, they won’t come back. If physicians don’t receive the
tools they need or adequate income for their efforts, they won’t stay.
If the staff doesn’t get adequate training or an encouraging work
environment that helps them do their jobs, they will find other ones.
If the practice doesn’t have the appropriate resources, it becomes
inefficient and unsustainable.
I’ve been fortunate to help many practices reframe their definition
of value, to look at value differently and realign the various aspects
of their business. When the medical practice works to ensure that
anything done adds value rather than detract from it, the end result
will be superior quality and outcomes, a premier work environment, and
highly engaged and trained staff; fostering increased profitability.