Payment & Delivery Models

What is value-based care? These are the key elements

Timothy M. Smith , Contributing News Writer

High-value care is about much more than containing costs. It’s also a recipe for improving patient outcomes, safety and satisfaction. But what exactly is it and how is it measured?

1 Quiz, 1 Question, 1 CME credit

Take the JAMA Network Challenge on JN Learning to get CME. It’s easy as 1 – 2 – 3.

1. Read the case.

2. Take the quiz – a single question.

3. Read the discussion & download your certificate.

An education module offered via the AMA Ed Hub™ helps medical students understand the concept of value and how it applies to health care. It also gives insights into the current state of value in U.S. health care, describes the essential components of—and barriers to—an ideal patient-centered, high-value health care system, and outlines specific ways physicians can promote high-value care.

The AMA Ed Hub is an online platform with high-quality CME and education that supports the professional development needs of physicians and other health professionals. With topics relevant to you, it also offers an easy, streamlined way to find, take, track and report educational activities.

The free online CME module—“What Are the Components of Value-Based Care?”—is enduring material and designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit™. It is one of nine modules released as part of the AMA Health Systems Science Learning Series.

Learn more about AMA CME accreditation.


Ways to define value. The National Academy of Medicine has developed a widely accepted approach that describes high-value health care as: safe, timely, effective, efficient, equitable and patient-centered—STEEEP for short. The Institute for Healthcare Improvement later translated this into a framework for action, the Triple Aim, which is made up of better patient outcomes, improved patient satisfaction and lower costs. The Triple Aim has since been expanded to the Quadruple Aim, which includes physician and health care professional well-being.

How to measure it. The health care value equation provides a way to understand how well an organization is performing vis-a-vis the vision of STEEEP and the framework of the Triple Aim. It is defined as the quality of care—made up of outcomes, safety and service—divided by the total cost of patient care over time.

Value is variable. The U.S. health system produces some of the best outcomes in the world, but also some of the worst, as measured by mortality amenable to health care. For example, the top five U.S. states would consistently rank near the top of developed countries, whereas the bottom five would trail them all.

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3 must-do’s for the move to value-based care

An ideal high-value health care system features six key components: a clear, shared vision with the patient at the center; leadership and professionalism of health care workers; a robust IT infrastructure; broad access to care; and payment models that reward quality improvement over volume. But the U.S. health care system was never deliberately designed to include these attributes.

Physicians play crucial roles in moving the health care system toward this model by minimizing low-value care and focusing on care that is high value and necessary. The first step is to identify and classify gaps that lead to waste, errors and missed opportunities. These include overuse, when care has a greater potential for harm than benefit; misuse, when appropriate care is selected but results in preventable complications; and underuse, when opportunities to provide high-value care are missed.

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7 barriers to implementing a health systems sciences curriculum

The AMA also recently released the Health Systems Science Review book, published by Elsevier. The review book complement’s the AMA’s 2016 Health Systems Science textbook, which outlines a formal method to teach students how to deliver care that meets patients’ needs in modern health systems. More than 5,000 copies have been sold worldwide, and it is being used in over 30 medical and health professions schools. Both books are available for purchase at the AMA Store.