A lead author, Peter Pronovost, MD, PhD, Chief Quality and Clinical Transformation Officer at University Hospitals and Clinical Professor of Anesthesiology and Critical Care Medicine at Case Western Reserve University in Cleveland, developed the concept of "defects in value." He and co-first author John W. Urwin, MD, of Beth Israel Deaconess Medical Center, Harvard Medical School, and the Department of Medical Ethics and Health Policy, University of Pennsylvania, wrote their model "offers a hopeful path forward for improving value in health care."
Using the success achieved at University Hospitals (UH) in Cleveland -- where annual costs per patient in the UH Accountable Care Organization (ACO) were reduced by 9 percent over the course of 12 months -- researchers demonstrated that deploying a framework in which specific 'defects in value' were eliminated could not only save money but improve the overall care value proposition. In the UH ACO, they applied this framework to the 37,000 members in its employee plan as well as the 580,000 patients in its ACO, who collectively represent almost half of the 1.2 million individuals for whom UH provides health care.