The Core Elements of Value in Healthcare

When you go shopping, do you simply go to the store with the intention of buying as many items as you can? Or do you select items based on the quality and satisfaction they will deliver for the money you spend? For most people, the quality of a product, relative to its cost, is most important. The field of healthcare today is making a similar distinction, placing a heightened emphasis on the delivery of value as opposed to sheer volume.

So what exactly does it mean to deliver value in healthcare? For decades, providers in the United States operated according to a model of volume-based care, under the general assumption that more care was better. In recent years, however, important developments in policy and payment and innovations in disease management, complex case management, population health, predictive analytics, and decision support have contributed to a paradigm shift toward value-based care. Organizations are now striving to eliminate waste, deliver higher-quality care at a lower cost, and increase patient satisfaction.

The Core Elements of Value in Healthcare provides a comprehensive introduction to value in healthcare as it relates to policy, delivery, finance, economics, strategy, public health, population health, operations, compliance, managed care, accountable care, and preventive medicine. The concepts of this book are reinforced through case examples and detailed discussion questions that encourage readers to apply the key principles as they learn.

Drawing from his experience as a physician, a hospital executive, and the founder of a medical group and health plan, Dr. Paveljit S. Bindra examines value from a variety of perspectives. Specific areas of focus include the following:

• Clinical innovations
• Alignment structures
• Payment reform
• Quality improvement
• Information technology

The Core Elements of Value in Healthcare equips readers with the knowledge to address disparate elements in the healthcare value chain, and it demonstrates how effective coordination of these elements can enhance the quality of care, reduce costs, and improve patient satisfaction and outcomes.

About the Author

Paveljit S. Bindra, MD, is the founder and CEO of the Imperial Health Plan of California, Inc. A licensed health plan, Imperial Health is responsible for delivering coordinated care to Medicare and Medicaid beneficiaries in several counties in California. It does so through managed care contracts, an integrated physician group, and contracted hospitals. Dr. Bindra has tested several of this book’s concepts at Imperial Health, with promising results.

Dr. Bindra has extensive management experience in hospital administration. He served as chief medical officer and chief information officer of a three-hospital, 625-bed acute care health system with an affiliated home health and hospice system. Prior to entering management and administration, he was a practicing cardiologist and electrophysiologist.

Dr. Bindra trained at Massachusetts General Hospital and the University of Pennsylvania. He attended Harvard Medical School (MD), Harvard College (AB), and the University of Oxford (MSc), where he was a Fulbright Scholar. He is also an adjunct associate professor at the University of Southern California Sol Price School of Public Policy.