The Brazilian Health Value Index (IVSB) is a national Value-Based Healthcare benchmarking and recognition initiative implemented across 583 hospitals, covering approximately 40 million lives in Brazil. It was created to address a fundamental challenge in Value-Based Health Care: how to fairly measure and reward value delivery across heterogeneous institutions serving populations with varying levels of clinical complexity. Based on a national retrospective cohort of hospital discharges from July 2024 to June 2025, the IVSB combines two equally weighted dimensions—risk-adjusted in-hospital mortality and efficiency measured through observed versus expected length of stay adjusted by DRG methodology—into a composite value score. Mortality is estimated through a supervised predictive model (XGBoost) with robust validation performance, ensuring fair comparison across institutions. By integrating clinical risk adjustment and operational efficiency, the IVSB operationalizes the value equation at scale and enables transparent benchmarking across medical conditions and care lines.
However, IVSB goes beyond measurement. It has already led to two national award editions, in 2023 and 2025, formally recognizing institutions classified as “Leaders”—those achieving performance equal to or above expected simultaneously in both quality and efficiency dimensions. The data supporting these recognitions derive from a structured national database built through standardized medical record review conducted by trained nurse coders under physician supervision, ensuring clinical accuracy and methodological consistency. The awards create peer recognition, stimulate healthy competition, reinforce accountability, and align executive leadership around outcome-based performance.
In addition to the award ceremonies, the initiative organizes regional events and a National Value Forum, fostering structured peer learning across institutions. During these forums, leading organizations present successful case studies, including the implementation of ICHOM-based patient-reported outcome measures, operational efficiency transformations, remuneration model redesigns such as bundled payments and risk-sharing agreements, and clinical governance innovations. Through this ecosystem, IVSB functions not only as a measurement infrastructure, but as a national benchmarking platform, a recognition mechanism, and a knowledge-sharing movement that accelerates systemic transformation toward outcome-based healthcare. By combining analytics, transparency, recognition, and collaborative learning, the IVSB creates cultural change and sustainable incentives for value delivery at scale.