Health systems after COVID-19 – Building resilience through a value-based approach

Health systems after COVID-19 – Building resilience through a value-based approach

18 Aug 2021

A Policy Paper from the European Alliance for Value in Health

Health system resilience has been rising in the political agenda throughout the last decade, becoming a key political priority. Even before COVID-19, the European Commission had defined it as a top policy item in 2014, focusing on factors that can reinforce it. The onset of COVID-19 presents rare momentum to realize ambitious reforms and establish a new paradigm for defining and building health system resilience, that will also answer the long-term health challenges Europe faces. The pandemic highlighted certain elements and dimensions of resilience, prompting the creation of scorecards and dashboards to navigate its multiple aspects, including contributions from the European Commission 2020 Strategic Foresight Report and the EU expert group on Health Systems Performance Assessment.

The European Alliance for Value in Health advocates for an even broader assessment of health system resilience, that is value-driven and people-centred, as this will strengthen health system resilience in emergencies and times of normalcy. The health systems of the future need to adopt an outcomes-focused and holistic approach, in order to reorganize the allocation of resources towards high-value care and prevention. This process builds off continuous learning processes, utilizing high quality, comparable data and insights. Special emphasis is placed on reaching high levels of health literacy and increasing the use of patient- reported outcome measures and experience measures (PROMs and PREMs).  Innovations in care delivery and integrated health and social care networks can be enabled by financing models and payments that reward value and outcomes. Importantly, investment in healthcare is recognized as an investment in societal well-being.

The Policy Paper connects the proposed value-based approach with health system resilience, demonstrating the synergy through a series of case studies. A set of specific recommendations is proposed, in order to draw a roadmap of actions, to be adopted by policy makers and stakeholders on a national, regional and EU level, including:

  • Incentivise health promotion and prevention;
  • Reform the framework for health funding both at the macro and meso level to facilitate a more holistic approach to health expenditure and financing;
  • Develop reimbursement systems, including value-based contract and risk-sharing models, that reward and support the adoption of high value innovation that satisfies unmet health needs;
  • Adopt national strategies for the collection and use of patient-reported outcome measures and experience measures (PROMs and PREMs);
  • Address legislative, organisational, knowledge and financial barriers to implementing digital health, telemedicine and homecare at full scale;
  • Empower and resource patient organisations to guide transformation to patient-centred care and support patients during times of crisis.

Critically, stakeholders should build coalitions at national and/or regional level to support the transformation to value-based and person-centred healthcare. These new partnerships will also strengthen the resilience of health systems during a crisis.

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