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Value in cardiovascular care
  1. Steven M Bradley1,
  2. Craig E Strauss1,
  3. P Michael Ho2,3
  1. 1 Center for Healthcare Delivery Innovation, Minneapolis Heart Institute, Minneapolis, Minnesota, USA
  2. 2 VA Eastern Colorado Health Care System, Denver, Colorado, USA
  3. 3 University of Colorado School of Medicine, Aurora, Colorado, USA
  1. Correspondence to Dr. Steven M Bradley, Minneapolis Heart Institute, 920 East 28th Street, Suite 300, Minneapolis, MN 55407, USA; steven.bradley{at}


Healthcare value, defined as health outcomes achieved relative to the costs of care, has been proposed as a unifying approach to measure improvements in the quality and affordability of healthcare. Although value is of increasing interest to payers, many providers remain unfamiliar with how value differs from other approaches to the comparison of cost and outcomes (ie, cost-effectiveness analysis). While cost-effectiveness studies can be used by policy makers and payers to inform decisions about coverage and reimbursement for new therapies, the assessment of healthcare can guide improvements in the delivery of healthcare to achieve better outcomes at lower cost. Comparison on value allows for the identification of healthcare delivery organisations or care delivery settings where patient outcomes have been optimised at a lower cost. Gaps remain in the measurement of healthcare value, particularly as it relates to patient-reported health status (symptoms, functional status and health-related quality of life). The use of technology platforms that capture health status measures with minimal disruption to clinical workflow (ie, web portals, automated telephonic systems and tablets to facilitate capture outside of in-person clinical interaction) is facilitating use of health status measures to improve clinical care and optimise patient outcomes. Furthermore, the use of a value framework has catalysed quality improvement efforts and research to seek better patient outcomes at lower cost.

  • Quality and outcomes of care

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  • Contributors SMB is responsible for the conception, design and drafting of the manuscript. CES and PMH are responsible for critical revision of the article. All authors approved the final version of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.