Value-Based Health Care : Dental Health Services Victoria Case Study

Over recent years, Michael Porter and Elizabeth Olmsted Teisberg’s Value Based Health Care model has been considered for implementation into areas of the Australian health system. The backdrop of this effort is the disease burden of 1 in 2 Australians having a chronic condition (2014-15 National Health Survey). One of the key goals of the delivery model is to consider the outcomes, rather than the actual treatment episodes. From a delivery perspective, it’s also to deliver outcomes that matter to patients over the cost.

Today’s health system has a number of significant financial challenges:
• Variations of the quality of health care delivery
• Growing population with increased chronic diseases and aging numbers increasing
• Rapidly evolving technologies that bring huge opportunity, at a cost
• Increased consumer expectations

Recently Australian Healthcare & Hospitals Association launched the Australian Centre for Value-Based Health Care (see where a case study was presented by Dental Health Services Victoria.

Early stages of the work included a visit to Harvard Business School, by Dental Health Services Victoria CEO Deborah Cole and Board Chair Dr Zoe Wainer. They met with Elizabeth Teisberg from the Value Institute for Health and Care at UT Austin and spoke to her at length on the model and the cultural variations in Australia.

What resulted was adaptation and co-design with consumers and clinicians of the model for dental health in Victoria. Planning also considered the cultural changes needed for the model to work in the Victorian oral health system.

After 3-4 years work, Dental Health Services Victoria has implemented a value based health model for oral health, around the patient and the clinician. This has been possible with a single oral health data system for the state of Victoria and staff keeping in mind the value and outcomes that patients seek.

During implementation small steps were necessary for changes needed in work practice and behaviour. New measurement included using International Consortium for Health Outcomes Measurement – ICHOM datasets on 23 patient reported outcomes as well as the reviewing the overall cost model.

The case study talks about some of the early indicators of success:

• Decrease in failure to attend rates
• Increase in dentists practicing to top of scope
• Increased preventative interventions
• Strong patient co-design, engagement and satisfaction
• Strong clinician engagement in Proof of Concept

The implementation continues at Dental Health Services Victoria, to capture patient experience, develop the best suited funding model and extending parts of the current model to the wider Victorian health system.

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