May 23

Healthcare Value Analysis and Utilization Management Isn’t Always About Saving Money: 3 Surefire Ways to Improve Quality Too

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When Larry Miles, the father of value analysis, invented the value analysis technique in the 1940s it was all about saving money. However, thanks to the evolution of value analysis by Value Analysis and Utilization Management Practitioners and Educators in the years that followed, VA & UM Practitioners now also focus on quality improvements of their products, services, and technologies. To up your value analysis game, here are three surefire ways to improve quality with value analysis and utilization management.

3 Surefire Ways to Improve Quality

With the advent of value-based purchasing, cost is just one of many factors that will affect your healthcare organization’s reimbursement. Henceforth, quality will also be monitored and compared against your peers’. Since the products, services, and technologies that your hospital, system, or IDN employs greatly contributes to the quality of your procedures, let’s look at three surefire ways to improve them through value analysis and utilization management:

  1. Infection Control: The products you buy can improve, decrease, or increase UTIs, CTIs, or MRSA infections. Therefore, you not only need to track and monitor infection rates when you introduce a new product claiming to reduce these rates, but you need to benchmark them with your peers. Why? Because even if you reduce infection rates, it might be a false positive.
  2. Under-Utilization: If you are utilizing less of a product than your historical usage, like bath kits, it could mean there is a quality problem. To determine this fact, you again need to track, monitor, and then benchmark your products to uncover these occurrences. This could indicate that your nursing staff is misusing them.
  3. Over-utilization: It’s the same with over-utilization. If your nursing staff is utilizing more products than your historical usage, like I.V. sets, your clinical staff could be replacing I.V. sets before it’s clinically necessary. Once more, you need to track, monitor, and then benchmark your products to determine why overutilization is happening.

So often value analysis is seen as a technique to only save money. However, as we have outlined above there can be quality issues that could be uncovered by the value analysis technique, if the VA practitioners broaden their definition of value analysis to include quality improvement. VA practitioners will then have a tool that is doubly effective in upping their healthcare organization’s value-based purchasing reimbursement.

Savings and Quality are Now Both Job #1 for VA Practitioners

Think of value analysis and utilization management as your healthcare organization’s product, service, and technology’s cost, quality, and outcomes’ arbitrator. Then you will see the linkage between value analysis and value-based purchasing. Furthermore, your hospital, system, or IDN can’t provide the highest quality care without your products, services, and technologies outpacing your peers’. That’s why savings and quality are now both job #1 for value analysis practitioners.


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healthcare, healthcare organization, Healthcare Value Analysis, hospital, IDN, reimbursement, saving, saving money, utilization, utilization management, value analysis


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