Value-based health care in four different health care systems.

While doing so for differing reasons, health care systems across the world over the past 15 years have increasingly embraced a value-based health care (VBHC) agenda.

As a concept, VBHC is easy to comprehend, but as a practical remedy it gets complex fast. No country has fully implemented VBHC.

To understand how system-level factors shape VBHC implementation, this 2020 review via NEJM assesses elements of VBHC in four different health care systems - Massachusetts (USA), the Netherlands, Norway, and England (UK) - representing a broad spectrum, from a public health care model to a more privately run model.

The paper examines the key factors that are enabling and impeding the functioning of the models, and formulate policy recommendations to accelerate and scale up adoption.

While value-based thinking already exists in different forms and shapes in all levels of the health care system today, the authors conclude that the theoretical framework and practical implementation function better in some countries than others.