Fair Fees For Patient Advisory Boards in Value Based Health Care

Revolution in health care

Since 2015, attention is paid to value-based health care in the Netherlands, which was introduced in 2010 by Michael Porter. Value-based health care has the goal to ensure that all actions and steps in the care process are meaningful for those whom the care is delivered to; the patient. To implement the transformation to value-based health care the patient will be given an important role as an expert and evaluator of health care so that the performance can improve, Tessa Richards writes in her blog “Power to the people through Paris on January 20, 2017 in the BMJ .

We need patients to clarify what works in the improvement of mental, physical and functional status, and quality of life. Earlier this year the OECD policy forum was held on “the future of health”. Everyone thinks “patient-centered health care” is a good plan. Clients become co-creators of their own health. In the Netherlands value-based health care was first embraced by the Santeon hospitals. Gradually value-based health care gets more attention in the care sector

value based healthcare

Sculpture by Henry Moore in his former gardens and fields at Much Hadham, England (Rick Ligthelm)

The patient as an expert in value-based health care

Increasingly the knowledge of patients is used to improve the care process. The Elizabeth Hospital in Tilburg invites, alongside the client council, other patients to adapt the new EPR to the needs of the patient as much as possible. A mixed group of patients of all ages and backgrounds will be involved to ensure a successful implementation.
The patients can use, by utilizing the available research data, information needed to take responsibility for their own recovery process. Many patients are seeking information about their disease process on the Internet and are well informed about the (im-) possibilities when they come to a doctor. The doctor will become a coach. According to medical experts that will be the reality for all medical care in 2025. Of course there will be patients who prefer a doctor as an expert. The developments go fast. Health insurers also follow this trend.

Achmea asked the director of the Association on Depression to rotate several months when purchasing care for the treatment of depression. It supplies knowledge and information on how to improve health care; simpler, cheaper and smarter. Information relevant to many others with economic value. Maison de Boer developed with young cancer patients at the Radboud Hospital, food that suits them. A positive development. This is how sensible care is created.

Current reimbursement client councils ‘dated’ in revolution

In most hospital and care organisations, the compensation of clients council who are involved in improving the process of care, housing facilities and the organization, consist of travel costs and a small fee for attendance. It is about a few hundred euros per year. This contrasts with a Supervisory Board which, depending on the size of the organization, get € 2,000 -15,000 per annum. In addition, they have a budget for participation in training, team building, coaching at evaluations, etc. Both bodies are meant to give independent advice.

Naturally a member of the Supervisory Board can be liable for incorrect or insufficient quality and safety of care. The client council represented by contrast all clients who use care in the organization. Many of the documents submitted to the Supervisory Board and Works Council also access the client council for advice or consent.

Now the client is seen as an expert and it is accepted and recognized that clients have valuable information, it is appropriate to adjust the compensation and support client councils to contribute in a professional manner. It may also be useful to appoint a client in the Supervisory Board instead of the representation of the client council. Clients who have been requested to participate in brainstorming sessions or innovative projects are equally entitled to a ‘fair’ compensation.

The economic value of a patient in the improvement of health care, appeared in the British Medical Journal in 2015. The revolution in health care with the patient as an expert challenges new business models.

By Carla Peeters

Carla Peeters is an independent expert in value  based healthcare and patient driven healthcare.

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