Principles for the effective implementation of value-based healthcare: a scoping review and proposed process model for successful implementation

Abstract

Abstract Background Porter's value-based healthcare (VBHC) idea has gained immense popularity in literature and practice in the past decade. While the value agenda clearly articulates the goal and content of VBHC, it provides no advice on an implementation strategy. This is problematic as, without an appropriate implementation strategy, even the most significant improvement initiatives are bound to fail. In this research, we adopt a change management perspective to understand better the critical principles that determine an effective implementation of VBHC. Furthermore, we provide guidelines to increase the likelihood of implementation success. Methods We performed a scoping review of the literature published in English on the topic of VBHC initiatives using Scopus and Web of Science. The studies were included if they offered empirical evidence on care providers' implementation of VBHC. Results The findings from the scoping review are based on 24 studies and underline that VBHC implementation is a complex concept. Implementing all ideas related to VBHC in practice appears to be challenging, and frequently, projects fail to measure or make progress in reducing costs and improving patient-centric outcomes. The findings also indicate that specific change management elements increased the likelihood of the VBHC implementation's success. The findings show the importance of 1) establishing the need and vision for change throughout the organization, 2) managing stakeholders' responses to change, 3) combining a supportive top-down and participative approach to change, and 4) using data on patient-centric outcomes and costs. Conclusion: The implementation of VBHC is a complex endeavor, demanding that the reason (why), content (what), and process (how) of the change to VBHC is well-developed. With no approach to VBHC implementation, there is little knowledge about the shift to VBHC from a change management perspective. By conducting a scoping study, this research aimed to systematically investigate the concept of VBHC implementation in the literature from a change management perspective by identifying and mapping the available empirical evidence on care providers' implementation of VBHC.