As policymakers, academics and other stakeholders focus on ways to extract better value from our healthcare system, it is critical that we recognize where our knowledge is insufficient to incentivize change at the pace and with the certainty that consumers need.
This report describes some of the specific gaps in our knowledge base that prevent us from getting to a system that delivers the right healthcare, at the right time, at the right price. Despite the myriad activity by payers and efforts of researchers, there are many areas where the evidence for or against interventions is inconclusive, key data are missing and an overarching research framework is absent. What’s more, one of the most greatly contested areas is the very definition of value in healthcare.
To learn where these gaps exist, we interviewed 14 researchers working in health services research and closely related fields. While the researchers universally agreed that we do not have enough evidence to get to healthcare value, there was a diversity of opinions about where these gaps lie. Several respondents, though by no means a consensus, assigned high priority to defining what we mean by “value,” identifying which healthcare services are valuable and which are not, and determining how to overcome resistance from providers that provide low-value care.
This report details the discussion around these research gaps and needs. The report also captures lively discussion about other types of barriers that keep us from getting to better healthcare value.
The researchers universally agreed that we need to be smarter about the types of research we fund and conduct. The lack of complete consensus around the highest priority items reinforces the need for some foundational work to establish an overarching infrastructure for this type of research and further clarify our goals.
Gaps in the evidence can be hard to see yet have a profound effect on the slate of strategies being considered by policymakers and other stakeholders and the types of research that get funded. We call upon researchers, funders and other stakeholders to establish and execute on a national agenda to fill gaps in critically needed evidence with respect to practices and policies that increase healthcare value.