cost v value
Know your worth
by Craig A. Solid

The need to accurately and comprehensively assess the value of the care you provide has never been greater, yet determining value isn’t an easy process and becomes an afterthought for many organizations. Truly assessing value has proven to be worth it for the organizations who pursue it.

As more people receive care at home, that value can’t be a simple measure of clinical practice quality or care-delivery efficiency. Understanding how to define, quantify and communicate value is crucial for companies looking to demonstrate what their product, device, process or service is worth.

Most of the organizations I work with have never invested in a value assessment before, so they’re a little unsure of what’s involved or what type of deliverable to expect. In 90% of these cases, the deliverable ends up being a version of one of three types of assessments:

  • A value brief
  • A white paper
  • A full economic analysis

Before we cover the details of what a value assessment includes, let’s cover some basics about what makes a value assessment credible and compelling:

  1. Value should be clearly defined. It’s also important to understand that value can differ depending on perspective (patients, providers, payers, etc.), situation, audience, goal and the data available.
  2. Value assessments should be rooted in data and/or published research studies, providing the credibility of the assumptions or estimates used to calculate value.
  3. Monetary benefits should be measurable, monetizable and attributable to what is being assessed.
    • Measurable benefits are those where valid and reliable data are available.
    • Monetizable benefits are those that can be clearly translated into financial terms. For example, if attempting to reduce falls in older adults, it may not be possible to monetize the benefit associated with avoiding any type of fall. Instead, it may only be possible to monetize the avoidance of an injurious fall.
    • Attributable benefits are those that are a clear result of the product, device, process, service or intervention being assessed. There are many threats to attribution, including other factors or concurrent interventions, inherent bias in patients or facilities being studied because of the use of convenience samples or other real-world limitations.

Regardless of which type of value assessment is being performed, each analysis should incorporate these key components to maximize effectiveness and be as informative as possible for the intended audience.

So, what are the three types of value assessments mentioned earlier? Here’s a brief description of each.

A Value Brief

A value brief is typically a two- to three-page document that includes a high-level summary with key statistics, a brief narrative and usually one or two tables or graphs to highlight key points. The value brief is meant to be outward facing—meaning that it is intended for payers, providers, patients, investors or other stakeholders. An outsider would immediately recognize it as marketing material; it would almost always undergo design and style reviews by the organization’s marketing or communications department. The message and format will be driven by who the intended audience is. The objective is to quickly relay to the reader the value of the proposed solution on a high level and in a way that is easily understood.

A White Paper

The term white paper is wonderfully ambiguous. It may reflect a rigorous academic research paper, but it is also used to refer to more informal communications about a topic or idea. For a value assessment, it typically represents a more thorough examination and summary of the available literature on the clinical topic, gaps in care and available solutions. It will be a longer narrative and incorporate tables and graphs in a way that is often seen in academic, peer-reviewed papers. A white paper is appropriate in situations when an organization wants to provide its audience with a more in-depth description of the potential opportunity and the impact of its solution, and to support it with a more extensive summary of the clinical and/or economic evidence. The result may be posted on a firm’s website or sent to individuals for whom the increased academic rigor would appeal—usually clinicians, payers, investors, funding agencies or acquiring organizations.

A Full Economic Analysis

As the most extensive and in-depth of the three options, a full economic analysis typically incorporates much of what is provided in a white paper and likely includes an even more exhaustive examination of the relevant literature to identify relevant numerical values that may be useful in calculations of metrics related to cost-effectiveness or return on investment. These may include values related to incidence or prevalence, rates of events, costs of care, potential reductions in adverse events or utilization associated with a particular solution, for example.

With these values, one then proceeds to calculate the estimated or realized economic impact of the device, product or service, as a way to demonstrate the business case. This process can be lengthy and should involve examinations of variability through sensitivity analyses or other methods. This type of deliverable is often used to support talks regarding potential contracts with payers or providers or those involving investors or acquiring organizations.

Determining which type of value assessment is right for your business will depend on several factors, including the intended audience, desired result/impact, timing, budget as well as other factors unique to your situation and solution. Luckily, these are general categories and the negotiated deliverable(s) can be tailored to meet your specific needs.

As you consider the value you wish to communicate about your solution and the audience whose attention you’d like to attract, understanding these common types of assessments can help you think in more detail about the data and processes you need.

Craig A. Solid, Ph.D., is a health care consultant with more than 20 years of experience. He is owner and principal of Solid Research Group, LLC, where he helps health care professionals and organizations measure and demonstrate the value of their research, quality improvement activities or services.