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Value transformation framework model seeks to guide transition to value-based healthcare


In response to rising healthcare costs, demographic trends and new technologies, the transition to value-based care is occurring throughout the healthcare system. The value-based framework reimburses providers based on quality of care, outcomes and cost, as opposed to a fee-for-service model that reimburses based on volume.

But to date, there has been no clear, standardized, organizing framework that federally qualified health centers can use as an “actionable pathway” toward system-wide change to advance value. This important group of health centers provides care to approximately 28 million patients across the U.S. — largely low-income patients facing social and environmental risk factors.

In response, the National Association of Community Health Centers has developed the Value Transformation Framework model, which provides a structured, step-by-step approach to help guide the shift to value-based healthcare, according to a new paper published in the Journal for Healthcare Quality.

The model seeks to guide systems change toward the “quadruple aim” goals of value-based care: improved healthcare outcomes, improved patient experience, improved staff experience, and reduced costs.


So far, the Value Transformation Framework shows promise in supporting efforts to adapt and balance competing demands, findings show.

Based on evidence-based and promising practices, the VTF addresses three health center system domains: infrastructure, care delivery and people. Within each domain are five change areas, providing well-defined but flexible steps toward improvement. For each of the 15 change areas, the model provides concise, step-by-step instructions in action guides to advance health center transformation.

The VTF model was field-tested as part of a two-year Cancer Transformation Project funded by the Centers for Disease Control and Prevention. Evaluation found a 13.6 and 6.5 percentage-point increase in colorectal and cervical cancer screening rates, respectively, during the first year.

Further steps included feedback from health center stakeholders, leading to fine-tuning of the Change Areas, and recommendations for further implementation. Initial results of VTF deployment in a national cohort of 115 health centers in 19 states will be available this year.

Although its intended audience is federally qualified health centers, the steps and actions described in the VTF may also apply to other health care organizations and networks, authors said.


The shift to value-based care is one of the biggest trends taking place in healthcare, yet there remain certain barriers to adoption — workflow challenges and interoperability among them, which can leave providers scrambling.

Efficiency is the goal of many healthcare organizations as they grapple with the transition to value, and enact potentially revenue-generating population health initiatives. The way the healthcare business is run today, it’s virtually impossible to do this without some kind of sound technological strategy in place.

Navigating value-based contracts is one area ripe for a technological assist. Many health systems have value-based care contracts with commercial payers, or perhaps have a Medicare Advantage component as part of their structure, which can achieve lower medical costs.

Twitter: @JELagasse

Email the writer: [email protected]


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