Advancing Value-Driven Care - Seattle-Denver Center of Innovation (COIN)
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Seattle-Denver Center of Innovation (COIN)

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Advancing Value-Driven Care

Our research advances the science of value-driven healthcare for patients with complex chronic conditions by:

1. Identifying the structure and processes used at high-value VA facilities
Value is defined as health outcomes achieved per dollar spent*. A high-value VA facility is one that achieves more health outcomes per dollar spent than another VA facility, even after controlling for differences such as facility size, facility location, or number of patients. An example of this can be found in dialysis care where some facilities have high costs and low health outcomes, while others have high health outcomes at lower costs. Identifying how a high-value facility functions helps VA leadership decide where and how to allocate funds for improved Veteran care. Learn more about our research that uncovers the secrets of high-value VA facilities in order to provide Veterans with quality healthcare that is also financially sound.   

2. Testing the comparative effectiveness of different ways to deliver high-value care
Healthcare today lacks strong evidence on what treatments are effective. In many cases where there is strong evidence, that evidence doesn't include the degree to which a treatment is effective for Veterans with complex chronic conditions. Research using a r
andomized trial has been the gold standard for deciding what treatments are effective, however they are expensive, time consuming, and generally don’t include patients with multiple chronic conditions. Comparative effectiveness research** is a faster, less-costly way to determine whether a treatment is effective and how the effectiveness varies for Veterans with complex chronic conditions. It compares existing treatments to see what works best and what poses the greatest benefits and harms for different patients or patient groups. Learn more about our research that helps VA leaders understand what treatments, interventions, and health care delivery methods deliver high-value care for Veterans.

3. Developing new methods to measure and analyze value    
This statistical research assists our other high-value research goals and includes developing a new generation of statistical methods to better identify the patient, provider, and system characteristics associated with higher extreme costs, developing innovative theoretical concepts for measuring cost, and adapting existing statistical methods to new uses to tackle difficult comparative effectiveness research questions. Learn more about our research that explores new statistical frontiers in order to identify, support, and predict high-value care.  

*   = Definition from Porter ME. What is value in health care? N Engl J Med 2010;363:2477-2481 and available here.
** = More about comparative effective research is available here.