Saudi Arabia - Health systems around the world face a value problem. Most G20 countries still pay for and organize health care around the volumes of services and products that healthcare providers offer, not around the outcomes that matter to people. That is why the Kingdom of Saudi Arabia’s recent leadership in prioritizing “people-centered health systems” in its 2020 G20 agenda is a bold and important step.
Around the world there is massive variation in health outcomes, regardless of health expenditure. Some G20 countries spend three times as much as others on health care while achieving lower life expectancy at birth. This is driven by not only an increased demand for services, but also by questionable spending on interventions and unnecessary bureaucratic tasks, in some cases accounting for as much as 30 percent of total expenditure.
The challenge of providing health care is particularly relevant for G20 countries where systems have been well established for years but need to adapt to new realities. This includes aging populations, the growing burden of chronic disease like cancer, cardiovascular disorders, diabetes, respiratory and mental health disorders, and new life-improving and life-saving medical technologies that cost more in the short term.
The strategy that can address this issue is “value-based care” (VBH). At its core, VBH is a health care delivery and payment model that focuses on maximizing value for patients — that is, providers are paid for the outcomes that patients achieve, not for the health interventions that they provide, achieving the best outcomes at the lowest cost. As a result, patients receive more value for their money, or better outcomes for the same or lower costs.
By outlining VBH and digital health solutions as essential enablers in health system transformation, the Kingdom has set an example for G20 countries and world.
VBH is particularly relevant for Saudi Arabia as it seeks to implement its government’s Vision 2030, and the National Transformation Program, which includes a huge investment in health care based on the National Healthcare Transformation Strategy. This lays out improved value for patients as one of three key objectives of the Ministry of Health, along with improved health of the overall population, and greater quality in the service itself. It lays out the key pillars of the VBH reform which provides a unique opportunity to build a system that is value, not volume, focused and which serves people, not providers.
But governments cannot achieve VBH alone. It requires collaboration with providers and patients. In some countries efforts to move from systems based on payment for services to ones based on payments per person were met by objections and boycotts. As a Brookings Institution publication advises, for reforms focused on value to succeed, policymakers must engage local communities and providers, strengthen primary care, monitor the effects of the system and hold providers accountable.
International organizations like the World Economic Forum (WEF) can play an important role in bringing together public and private actors to make progress. For example, the Global Coalition for Value in Healthcare, co-founded and hosted by the WEF, is well positioned to support and enable countries efforts towards implementing VBH by working with the world’s leading experts to accelerate the pace of health system transformation.
The Saudi Arabian minister of health, Tawfiq Al-Rabiah, is expected to become a member of the executive board of the Global Coalition for Value in Healthcare.
Paradigm shifts are difficult to implement, especially in countries with established health systems and health stakeholders entrenched in doing business athe old fashioned way. Now is the time to radically rethink the way we deliver care, so we can achieve the goal of universal health coverage and make health and health care stakeholders fit for the future.
Dessislava Dimitrova is head of healthcare transformation, shaping the future of health and healthcare at the World Economic Forum.
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