+Valor

+Valor

mapcare

Brazil has a complex fragmented private health system composed of self-employed physicians, open clinical-staff hospitals and health insurance reimbursement. While the major cost driver is acute care, most of the care cycle takes place at outpatient facilities with potential to turn a patient-centered approach into earlier diagnoses and lower complications. Mapcare´s +Value initiative aims to enhance Brazilian providers alignment with VBHC by preparing outpatient healthcare organizations to collect outcome data, measure costs and exchange information around similar medical conditions through the complete cycle of care. The initiative started in 2017 with Vita +Value, our pilot project in orthopedics. The condition selected was osteoarthritis, the most common joint disorder in Brazil. It affects about 10% of the general population and is likely to increase due to the aging population and obesity epidemics. We developed an implementation process to ensure that outcome measurement and cost analyses are translated into action as part of the organization’s daily routine. The first step was involving the management and care team as partners in this effort. A hip osteoarthritis multidisciplinary team was set up to discuss a detailed care manual with treatment protocols. In collaboration with patients, the team developed digital questionnaires to collect outcome data according to ICHOM standards. Outcome measurement is at an early stage, but regular meetings are now held to look for improvements in the implementation process. Mapcare’s team is also developing process maps and calculating resource capacity to obtain key cost indicators.  A collaboration network was established with national partners to consolidate outpatient, inpatient and exam information through the complete the cycle of care. According to the value-based framework, we expect that having outcomes results will help increasing patient’s engagement, reducing risk factors and minimizing complications with an earlier approach. We also expect the Vita +Value initiative will open the discussion for value-based agreements. By accurately projecting costs and outcomes, we hope the organizations that implement Mapcare’s +Value initiative will have information to deliver superior patient value and discuss bundle payments and value-based agreements with health insurers.