Unlike the traditional fee-for-service payment model, which has been used by physicians since antiquity, the value-based framework rewards the healthcare provider not based on the amount of delivered services, but on the impact of the medical interventions on the patient's wellbeing.
“The main change if a patient goes to a value-based healthcare center is that fee will be connected in many ways to the outcome," says Majid Kaddoumi, Vice President of Medtronic, one of the pioneers of value-based care in Dubai.
Value-based healthcare outperforms the old model in a number of ways, putting right the many shortcomings of the fee-for-service system. The old model incentivizes the healthcare providers to increase the number of services they perform, though—at a personal level—doctors may not intend any unethical behavior.
Critical thinkers such as Nassim Nicholas Taleb, meanwhile, have been warning the world that unnecessary medical interventions may be far more harmful than helpful and that avoiding blindfolded interventions may save just as many lives as the delivery of right healthcare services in a timely manner. What is more, specialists sometimes fall victim to a certain kind of tunnel vision, focusing only on the symptoms and organs they are treating, while ignoring the bigger picture and the fact that the human body is a highly interconnected system.
Value-based healthcare—with its emphasis on holistic rather than local results—encourages healthcare providers to remain mindful of the larger scheme of things, while promoting the culture of cooperation between different healthcare specialists. Although value-based healthcare is highly patient-centered, it is also a win-win deal benefiting all stakeholders in some way or another.
The model encourages practitioners to constantly expand their horizons and skills. The feedback provided by value-based healthcare, meanwhile, helps hospitals and clinics recognize the merits of their most high-performance personnel, while helping them to single out and retrain those whose services fall short of expectations. All this has placed value-based care at the forefront of healthcare management, with many national and private providers taking an interest in the model.
Dubai Health Strategy 2016-2021, whose number-one objective is positioning Dubai as “a global medical destination," places an emphasis on the introduction of “a value-based, comprehensive, integrated and high-quality service delivery system." In 2019, Dubai and the other Emirates are closer to accomplishing this objective than ever as this year's federal budget has set aside some AED4.4 billion for the healthcare system—an all-time high in the history of the UAE. In parallel with the shift to value-based care—and largely as a result of it—healthcare in Dubai is also becoming personalized. “One size fits all" solutions, after all, are not famous for their quality.
The delivery of personalized care is further facilitated by the rise of AI, big data, and cloud computing, which allow providers to keep track of a patient's diagnostic history, lab results, and other medical records.
If kept on cloud computing platforms, these valuable databases will be accessible to different healthcare providers across the UAE, while AI solutions search for meaningful patterns in each individual's medical history, compare them to the rest of the population, and even assist the medical team in pronouncing the right diagnosis. In short, data collection and processing are an indispensable part of value-based care. In 2017, Dubai Health Authority (DHA) launched the final phase of the Emirate's unified medical records platform—known as the Salama initiative—which gives the qualified DHA employees quick access to records, thus reducing costs and opening up many new possibilities.
Given Dubai's status as a medical hub in the MENA region, the Emirate can also become a regional leader in this emerging brand of healthcare. Medtronic has been one of the early players in Dubai's value-based care, and Kaddoumi observes that “there is still more to serve, as this region has about 1.5 billion people," adding that “Dubai has made it easier for us to access these markets."