What Actually Fixes Health Care: From Activity to Outcomes
Health care systems often prioritize activity over outcomes due to entrenched incentive structures that reward volume rather than value. This fee-for-service model can lead to fragmented, inefficient care even when individual services are delivered well. Shifting to value-based care—aligning payment with patient outcomes over time—offers a path to more effective and sustainable health systems.
- ▪Health care systems are complex adaptive systems that become fragile when overly standardized.
- ▪Current incentive structures often reward volume of services rather than improvements in patient health.
- ▪Fee-for-service models contribute to fragmented care, even for chronic conditions like diabetes.
- ▪Value-based care focuses on patient outcomes across the full continuum of care, not isolated procedures.
- ▪Changing the system's incentives can shift behavior toward long-term health improvement.
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...By Lawrence Rosenberg, MD, CM, MSc, PhD, MEng, FRCPSC, FACS, FCAHSPresident & CEO, Integrated Health & Social Services University Network for West-Central MontrealShareNewsweek is a Trust Project memberSee more of our trusted coverage when you search.Prefer Newsweek on Googleto see more of our trusted coverage when you search.Over the first two articles in this series, we have reframed how health care systems behave. They are not machines to be optimized, but complex adaptive systems that evolve through countless interactions. When they are tightly controlled and overly standardized, they do not become more stable; they become fragile – drifting toward the kind of critical state where small disruptions can trigger system-wide crises.
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