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Value Based Care and Patient-Centered Care: Divergent or Complementary?

Abstract

Two distinct but overlapping care philosophies have emerged in cancer care: patient-centered care (PCC) and value-based care (VBC). Value in healthcare has been defined as the quality of care (measured typically by healthcare outcomes) modified by cost. In this conception of value, patient-centeredness is one important but not necessarily dominant quality measure. In contrast, PCC includes multiple domains of patient-centeredness and places the patient and family central to all decisions and evaluations of quality. The alignment of PCC and VBC is complicated by several tensions, including a relative lack of patient experience and preference measures, and conceptions of cost that are payer-focused instead of patient-focused. Several strategies may help to align these two philosophies, including the use of patient-reported outcomes in clinical trials and value determinations, and the purposeful integration of patient preference in clinical decisions and guidelines. Innovative models of care, including accountable care organizations and oncology patient-centered medical homes, may also facilitate alignment through improved care coordination and quality-based payment incentives. Ultimately, VBC and PCC will only be aligned if patient-centered outcomes, perspectives, and preferences are explicitly incorporated into the definitions and metrics of quality, cost, and value that will increasingly influence the delivery of cancer care.

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Acknowledgments

Many thanks to Dr. Kelvin Chan for providing editorial assistance with this manuscript.

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Correspondence to Lisa K. Hicks.

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Eric K. Tseng and Lisa K. Hicks each declare no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Health Economics

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Tseng, E.K., Hicks, L.K. Value Based Care and Patient-Centered Care: Divergent or Complementary?. Curr Hematol Malig Rep 11, 303–310 (2016). https://doi.org/10.1007/s11899-016-0333-2

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  • DOI: https://doi.org/10.1007/s11899-016-0333-2

Keywords

  • Health economics
  • Patient-centered care
  • Value-based care
  • Cancer care