Value-based assessments are moving into healthcare and may become the newest, potentially greatest barrier to care for vulnerable populations. What’s critical is understanding what the accessor considers to be of “value”.
Value assessment advises health insurers, and government whether a health treatment should be used, for who and under what circumstances. Most assessments look at the costs, health benefits and risks of the treatment or technology in question. This sounds like a sensible thing to do but it is critical that the patient experience is added into the equation.
Without thinking about the people involved, the patient experience, a cure that treats a small segment of the population may not be considered to have value and remain unavailable to the population it cures. A surgery that marginally improves a condition may not be considered to have value in a strict cost analysis, but the improvement to the patient may be life changing. Perhaps patients over a certain age don’t respond consistently to a medication. Does no one over that age get access to the medication though some of them would respond well?
Until other factors, particularly the patients’ experience and benefit to the patient, are added into the equation, value assessments are barriers to potentially lifesaving and life-changing treatments and injurious to the patient. Institute for Clinical and Economic Review (ICER) is one company making the value-based assessments. CCPA gives testimony and monitors their assessment processes.