Key result
Value-based healthcare implementation in cardiology remains nascent, hindered by fragmented infrastructure and unaligned reimbursement.
Why the study?
Value-based healthcare models could yield substantial savings and improve patient experience, but their adoption and development remain challenging.
Does the implementation of value-based healthcare (VBHC) models improve the care process, patient experience, and cost optimization in cardiology and cardiac electrophysiology?
Systematic Review
Does the implementation of value-based healthcare (VBHC) models improve the care process, patient experience, and cost optimization in cardiology and cardiac electrophysiology?
This scoping review demonstrates that while value-based healthcare models in cardiology and electrophysiology have the potential to optimize costs and improve patient experience through tools like remote monitoring and same-day discharge, actual implementation remains in its infancy due to infrastructural and reimbursement barriers.
Urges caution against expecting VBHC gains in cardiology now; leaves open targeted trials once infrastructure and reimbursement barriers are resolved.
AIMS: The accomplishment of value-based healthcare (VBHC) models could save up to $1 trillion per year for healthcare systems worldwide while improving patients' wellbeing and experience. Nevertheless, its adoption and development are challenging. This review aims to provide an overview of current literature pertaining to the implementation of VBHC models used in cardiology, with a focus on cardiac electrophysiology. METHODS AND RESULTS: This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Scoping Reviews. The records included in this publication were relevant documents published in PubMed, Mendeley, and ScienceDirect. The search criteria were publications about VBHC in the field of cardiology and electrophysiology published between 2006 and 2023. The implementation of VBHC models in cardiology and electrophysiology is still in its infant stages. There is a clear need to modify the current organizational structure in order to establish cross-functional teams with the patient at the centre of care. The adoption of new reimbursement schemes is crucial to moving this process forward. The implementation of technologies for data analysis and patient management, among others, poses challenges to the change process. CONCLUSION: New VBHC models have the potential to improve the care process and patient experience while optimizing the costs. The implementation of this model has been insufficient mainly because it requires substantial changes in the existing infrastructures and local organization, the need to track adherence to guidelines, and the evaluation of the quality of life improvement and patient satisfaction, among others.
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Osoro et al. (2024) conducted a systematic review in Cardiovascular diseases and cardiac electrophysiology. Value-based healthcare (VBHC) models (including remote monitoring clinics, cross-functional telemetric networks, same-day discharge programs, and shared decision-making programs) vs. Traditional fee-for-service healthcare models was evaluated on Implementation status, patient-centric solutions, policy levers, payment schemes, and adoption challenges of value-based healthcare models in cardiology and electrophysiology. Value-based healthcare implementation in cardiology and electrophysiology remains in its infant stages across 51 reviewed documents, hindered by fragmented infrastructure and unaligned reimbursement.
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