Mahek A. Shah, MD, senior researcher and faculty member at Harvard Business School, discusses the shift in healthcare to a value-based system. Dr. Shah’s background in investment banking, solving large-scale problems for clients, stimulated a passion to take a similar mindset and approach to healthcare improvements. Dr. Shah’s mission is to bring more humanity to the healthcare system by creating higher value for patients, providers, payers, and people worldwide—bridging the business world with healthcare delivery.
As a senior project leader and senior researcher at Harvard Business School, Dr. Shah oversees Harvard’s Value Measurement for Health Care projects, which critically analyze time-driven activity-based costing (TDABC) globally in order to fully grasp the true, actual costs of healthcare delivery. Additionally, Dr. Shah advises executives who manage large health systems and companies, educating and arming them with tools to measure their outcomes and overall costs.
By working for improvements at the patient level, on the front lines of healthcare delivery, Dr. Shah hopes to make big strides in the advancement of healthcare systems. Shah’s team works specifically with individual conditions, from chronic to acute, and by studying the way patients are managed they can offer advice and consultation for dramatic improvements. Their critical analysis of procedures and processes can provide key insight to healthcare managers, etc. helping them to understand how they can create value in their system. As Dr. Shah explains, true value exists at the patient level, and healthcare systems need to focus more intently on the needs of their customers—the patients.
Dr. Shah details how the current model incentivizes based on ‘fee for services’ such that physicians are rewarded for selling services, but this model does not ensure that the patient’s needs are truly serviced. The key is to get systems to move forward to a value-based healthcare platform, much like other industries have implemented with great success.
While Dr. Shah believes that most people in healthcare have chosen that path in order to provide what is best for patients, the system of providing that care can be complex. Dr. Shah underscores that it’s a very important time in healthcare as there are so many moving parts. As he explains, if the value is defined as the outcome that matters to patients over the cost of delivering that outcome then an analysis of this will make it is possible to find ways to increase the value equation from a directional standpoint.
Success, as Shah states, is measured by functional outcomes, and systems should be looking at what the true cost is to deliver those outcomes, at the patient level. He discusses the importance of regular follow-ups after procedures and during recovery, and how costs can increase when follow up is not part of the system’s plan. Dr. Shah details three criteria he looks for in healthcare-based projects, to ensure that they are meaningful, actionable, and hopefully replicable in other areas of a system’s organization. As healthcare systems improve it will be the analytics that can deliver valuable insights into their operations, and most importantly, at the point of care for the patient.