Value-Based Healthcare Services

Leveraging cross-functional skillsets to deliver operational efficiencies and ‘value’ across the entire healthcare spectrum

Need for Value-Based Approach in Healthcare

Value-based healthcare (VBH) is a healthcare delivery model in which providers are rewarded for helping patients improve their health, reduce the effects and incidence of chronic disease, and live healthier lives in an evidence-based way.

Value-based care differs from a fee-for-service or capitated approach. The ‘value’ in value-based healthcare is derived from measuring health outcomes against the cost of delivering the outcomes.

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Key Challenges

How Do We Help?


Facilitating a team-oriented approach to patient care

Driving operational efficiencies to reduce overall cost of healthcare delivery

Defining robust measures of quality and patient engagement

Accelerating the sharing of patient data across disparate systems and organizations

Actu-Real’s Value-Based Healthcare Services

Risk-sharing agreements

  • Risk assessment and quantification
  • Definition of outcomes for risk-sharing
  • Data capture and real-time analytics
  • Governance – monitor metrics

Value-based pricing

  • Model uncertainty around translation of risk-benefit profile to real world
  • Estimate post-launch

Actuarial cost modelling

  • Modelling cost & utilization to estimate financial impact of a new treatment
  • Projection & allocation of net health care costs
  • Scenario analysis for budget impact

Evidence-based strategies to enhance quality and contain costs

  • Predictive modelling based on real world data sources
  • Cohort segmentation
  • Develop personalized

The Actu-Real Advantage

Breadth and depth of expertise across drug development, commercialization, data sciences, actuarial science and technology
Innovative solutions in areas of value-based healthcare to help manufacturers and payers understand market performance before launch
HERCULE™ - A modular platform with pre-configured statistical models that can be readily deployed to ingest, analyze and visualize real world data
Combination of domain expertise and operational efficiencies along with advantages of a global delivery model


Value-based healthcare is a framework that encourages healthcare providers to focus on quality of care than quantity. The value in such a model is derived from measuring health outcomes against the cost of delivering the outcomes. The providers’ rewards are linked to patient health outcomes using evidence-based approach, where outcomes may be better overall health, reduced adverse effects or prevention of chronic diseases.

The fundamental principle is ‘pay-per-outcome’, rather than ‘pay-per-pill’. Value-based pricing is determining the price of a therapeutic intervention based on the therapeutic value (TV), including its effectiveness, and health outcomes. Value beyond clinical and economic outcomes may also be included, such as equity, quality of life for caregivers, or better patient adherence. The therapeutic value, and value-based pricing is determined in comparison with other available treatment options.

Two main barriers to adopting and implementing VBH are fragmented delivery of care by specialty, and disconnected data systems. Institutions could overcome these by looking to set up integrated practice units around disease conditions and have well connected data systems that are not siloed and can interact with each other seamlessly – this means having a good technology platform that ensures up-to-date patient data are readily available to all healthcare providers enabling them to make well-informed decisions keeping patient health at the core.

Physicians/providers possibly have the biggest role to play in VBH, but for the system to be successful every stakeholder needs to contribute including patients, employers, insurers, governments/policy makers.

For VBH to work, all stakeholders need to be in alignment to ensure a collaborative promotion of the concept of health system value – this is easier said than done. But if accomplished, it has something for everyone: would help systems become efficient, remove unnecessary costs, and ultimately lead to patients spending less time in hospitals and being healthier. This in turn will result in patient loyalty, patients would want to return to a set-up that brings value and is coordinated. From the payer’s perspective too, it would lower the risks, as such systems inherently would try to reduce errors, re-hospitalizations, and incorrect/inefficient treatments and procedures, thereby improving cost-efficiency. From the manufacture’s perspective, it would mean a fair price for the drug by alignment of prices with patient outcomes.

Since VBH keeps patients’ health at the core of everything, it ensures providers and system work in an integrated manner, striving for better overall health of patients at all times. This inherently reduces errors and incorrect treatments thereby lowering the chances of complications and negligence.

There are several challenges which can vary by country since they depend on who pays for healthcare, and how. One of the fundamental difficulties is to arrive at a definition of value (of care) that’s relevant and acceptable to all stakeholders. This includes definition of health outcomes. After outcomes are defined and agreed, there’s a huge operational burden of measuring these outcomes in patients over the time horizon included in the definition. This involves tracking and monitoring the patients, measuring the outcomes, capturing the data, and linking it to payments. For certain interventions that have high upfront costs (such as cell and gene therapies), while outcomes are realized over a long period of time, alternative payment models are very hard to define when only short time periods are of relevance to the payers.

Availability of complete and up-to-date patient data is key for providers to come up with the most appropriate treatment regimen. The data need to flow seamlessly within the system, should not be siloed, and should be easy to enter and track. Investing in a good technology platform that enables interaction and integration of data across departments and locations could tremendously improve data availability at the individual and institutional level, and ensure a successful VBH set-up.

Value-based care model through its integrated systems across departments/hospitals would reduce duplication of work, thus decreasing costs and improving performance. Additionally, the goal of maintaining overall good health of patients encourages providers to look for more preventive measures rather than settle on current treatment for the condition, thus bringing in cost-efficiency. By moving away from the fee-for-service model, there would be reduced prescription of unnecessary tests/procedures that would reduce costs. This model will also help institutions focus on making processes more streamlined and efficient, thereby bringing down overall costs.

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      Actu-Real Inc.

      Actu-Real offers solutions and services to help payers, providers and pharmaceutical companies optimize objectives of access, quality and cost of healthcare, with the backbone of a fit-for-purpose, all-in-one technology platform for data integration, advanced analytics, reporting and visualization.


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