The added value of integrated care
Value-driven care: also known in the corridors as the holy grail for solving all problems in the healthcare sector. Whether it concerns care for people with one chronic disorder, patients with multi-morbidity or the care of frail elderly people, value-driven care is seen as the solution. Chain care, network care, value-based healthcare, integration, substitution and transformation – these are all concepts that come up and are often mentioned in the same breath. But what exactly are we talking about? And more importantly, does it really make sense to organize care in a value-driven way?
Why value-driven care?
Value-driven care is seen as the way to organize care sustainably. The population is ageing, patients have different demands and conditions are more chronic than ever. The demands placed on individual care providers and care organisations, as well as the government, are therefore changing and the current organisation of care is not in line with these changes. The concept came over from the United States
Triple Aim
a threefold objective that must be pursued simultaneously. The first objective is to improve the perceived quality of care, i.e. the experience of people who come into contact with care as patients. Secondly, it is about improving the health of a population. The third objective is to reduce healthcare costs, to ensure that good care can be provided to everyone in the future.
Creating value
In practice, value-driven care is the term used to describe a group of healthcare providers who have 
A coordinated way of working together to improve the health outcomes of a population or sub-population. The group of providers is jointly responsible for the realisation of high-quality care and for the costs of that same care. This approach therefore goes a step further than Michael Porter’s current approach in the Netherlands
value based healthcare
Michael Porter’s approach in the Netherlands, because it is only about chain optimisation within the walls of one organisation, usually the hospital. Value-driven care requires the organisation of care across the entire network of prevention, care and welfare. One possibility is intensive cooperation between primary care professionals, medical specialists in a regional hospital and welfare organisations. In practice, this can only be achieved through effective cooperation between multiple organizations. In other words, integrated care is essential to realize value-driven care.
So, is it working?
A logical question is whether the effects of value-driven care have already been found in practice. Insight into the effectiveness of value-driven care begins with insight into integrated care. Until recently, there was little evidence of the effect of integrated care. It is therefore a difficult
subject: there are many different forms of integrated care in practice. A good way to classify these different forms and projects was not available until recently. The lack of a good theoretical model and reliable measurement instruments means that the research is fragmented and it is difficult to draw conclusions.
In other words, the effect of integrated care has hardly been substantiated with research results in the scientific literature. Insight into the various forms of integrated care is, however, necessary in order to determine the added value of an approach (intervention, programme, organisation or partnership) in practice. Effective collaborations and organizational relationships can thus serve as examples for other healthcare providers and suppliers.
The Rainbow Model for value-driven care
As mentioned, until recently there was no model that provided insight into all levels of integrated care and in which the various forms of cooperation all had their place. With the Rainbow Model for value-driven care this is now possible. The Rainbow Model represents the different levels and forms of integrated care in one model. The Triple Aim, the three objectives of value-driven care, have also found their place in this model.
The Rainbow Model is divided into 4 different domains. The micro level focuses on the coordination of care for an individual (one patient), the meso level is about the coordination of care between (healthcare) professionals and between organisations, and the macro level concerns the laws and regulations of the healthcare system. The preconditions for cooperation at all these levels have a central place in the model. Because value-driven care stands or falls with people; people who can work together in teams inside and outside their organisation in a context of trust and innovation. This requires the right balance between functional (e.g. financing, data management) and normative (vision, interests) preconditions. The balance between these preconditions ultimately determines whether an approach can be successful in practice. The Rainbow Model summarizes the various domains of value-driven care and the hard and soft preconditions in one model.
Invest in integrated care
Integrated care is the way to organize care in a sustainable way. It is the first essential step towards value-driven delivery of care. It is even necessary to achieve the best care and health of the patient at the lowest possible cost in the long run. That’s why it’s wise to measure the state of integrated care in your organization. With the help of the Rainbow Model you can map, compare and research collaborations and projects.
We have also developed various measuring instruments based on the model. How do patients experience the quality of care? And do caregivers experience fragmentation or integration? By means of the
measuring instrument integral care
based on the Rainbow Model, you can collect the experiences and opinions of both groups to get a clear picture of the current level of integration. This gives you direct insight into the strengths of your organisation and the areas for development.
Want to know more?
Do you want to get started with integrated and value-driven care? Check out
h
here the interactive Rainbow model
! Or download the free e-Book.
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Healthcare networks that work: the key to better outcomes
Integrated care is seen as the solution to improve the accessibility, quality, patient satisfaction and efficiency of care. Network care is therefore not an end in itself, but a means to realize value-driven care, also known as value-based healthcare or triple aim. In this e-book, you will read what a healthcare network is and we will identify the barriers and solution directions for practice. Based on the Rainbow Model and (inter)national best practices.
