Value-based healthcare in theory and practice: What have we learned? Lessons from the Swedish experience

In recent years, value-based health care (VBHC) has been launched and promoted as the new way of addressing the challenges facing the health care sector. Sweden has been a fore-runner and the concept was actively advocated during the past decade. Sweden was considered to have an advanced healthcare system with vast experience of measurements, hence a perfect place to implement the full concept of VBHC.

As experience grew, so did criticism. The Swedish opinion definitely started to shift in 2016 and although some of the work is continued, today the concept is rarely used. However, these experiences have not been widely recognised in Europe and elsewhere. Nor have they been analysed or fully understood.

In order to strengthen the state of knowledge, the Swedish Ministry of Health and Social Affairs therefore commissioned Leading Health Care Foundation, a Swedish independent academic think tank, to analyse VBHC from a broader, organisational perspective and taking the Swedish experiences into account.

The results indicate that VBHC, even though launched as something new, is a management concept comparable to and being a blend of previous concepts and models. Notably, VBHC claims to have a system-wide application and is put forward as a solution suitable regardless of contexts, care settings and political/cultural differences. This is a recurring feature of popular management models and an attractive feature for decision-makers – but calls for cautiousness. The one-size-fits-all-model tend to wither in the meeting with heterogeneous practices.