On the road to efficient value-based healthcare
Across the globe, there’s a common trend towards hospital consolidation and the creation of hospital groups and networks to reduce costs and increase quality and access to care.
In line with this trend, the Belgian government introduced a reform of the hospital landscape, which included the creation of local-regional clinical hospital networks to encourage collaboration in the provision of clinical services. However, the absence of a financial reform before the creation of these networks, and the peculiarities of the Belgian hospital landscape have led to several challenges in reaching coordinated, efficient and value-based care - the intended outcomes of the reform.
A Belgian approach to reform
Belgian hospitals took a rather unique approach to the creation of hospital networks. Rather than taking geography, performance, expertise or finance into consideration, they created networks according to philosophical and personal connections. As a result, the importance of geographical proximity - a logical convenience for the patient - has been overlooked. The resistance to learn from other countries has also hampered progress. In terms of reducing costs and improving effectiveness, learning from other countries’ experiences could have sped up the process by several years. Add to the mix the absence of a financial reform before the networks were established and it’s clear that reaching coordinated, efficient and value-based care will be hard to achieve.
The view of an industry leader
In his role as President of The Belgian Association of Hospital Managers, Paul d’Otreppe has been following these developments closely.
In an interview with Michèle Paque, healthcare and life sciences specialist at PwC, Mr d’Otreppe discusses the mistakes that were made and outlines what needs to be done to achieve the ultimate goal of value-based healthcare, with quality for the patient at its core.
A first step is to introduce coordination to manage the system, processes and rules. There’s a lack of integration between the different lines - GPs, general hospitals and universities - and so the patient doesn’t benefit from one clinical pathway.
The second issue to tackle is finance. Moving to an outcome based model, hospitals would receive a bundle payment for the treatment of a pathology, thus reducing the number of unnecessary scans and tests. The truth is that 25% of what hospitals spend has no benefit for the patient. By eliminating this kind of waste, there’ll be more money to invest in prevention. But a reform of networks means looking at the performance of individual hospitals, an extremely sensitive topic. In the future, defined metrics to measure and evaluate the efficiency of a hospital will become increasingly important.
Contact us
Michele Paque
External Senior Advisor, Life Sciences and Healthcare, PwC Belgium
Tel: +32 477 60 50 51
