Navy Medicine Introduces Value-Based Health Care

Health Affairs
Alee HernandezMichael E Porter

Abstract

In 2016 the newly appointed surgeon general of the Navy launched a value-based health care pilot project at Naval Hospital Jacksonville to explore whether multidisciplinary care teams (known as integrated practice units, or IPUs) and measurement of outcomes could improve the readiness of active duty personnel and lower the cost of delivering care to them, their dependents, and local retirees. This article describes the formation of the project's leadership structure, the selection of four conditions to be treated (low back pain, osteoarthritis, diabetes, and high-risk pregnancy), the creation of the care team for each condition, outcomes and costs measured, and the near-term changes in outcomes during the twelve-month pilot period. Patient outcomes improved for three of the four conditions. We describe factors that contributed to the project's success. After the pilot concluded, the Navy combined the back pain and osteoarthritis IPUs into a single musculoskeletal clinical unit and established a similar IPU at another naval hospital and its clinics. The diabetes IPU was continued, but the high-risk pregnancy IPU was not. We offer several observations on the elements that were key to the success of the project, explore challenges...Continue Reading

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Dec 14, 2016·The New England Journal of Medicine·Robert S KaplanJonathan Warsh
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Citations

Apr 14, 2020·Neuromodulation : Journal of the International Neuromodulation Society·Alaa Abd-ElsayedAhmed M Raslan
Oct 19, 2020·The Journal of Arthroplasty·Tanmaya D Sambare, Kevin J Bozic
Jul 1, 2021·Journal of Healthcare Management / American College of Healthcare Executives·Bruna Stella ZanottoCarisi Anne Polanczyk

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