Value-Based Health Care Delivery in Cardiovascular Care: Review of Models and Outcomes

Health care systems globally are under growing strain due to rising costs, aging populations, and the increasing burden of chronic diseases, alongside inefficiencies in service delivery. Traditional fee-for-service models, which incentivize the quantity rather than the quality of care, have often led to fragmented services, inconsistent outcomes, and escalating expenditures. VBHC has emerged as a model that emphasizes delivering the best possible patient outcomes relative to the cost of care across the entire care continuum. Key features of VBHC include coordinated, outcome-focused care, systematic measurement of clinical results and costs, team-based collaboration, and linking reimbursement to performance. VBHC in cardiovascular care is implemented through integrated care models, bundled payments, and accountable or population-based payment systems. Integrated models use multidisciplinary teams to coordinate care across the continuum, reducing readmissions and improving clinical and patient-centered outcomes. Bundled payments align financial incentives across an episode of care to promote cost control, quality improvement, and reduced care variation. Accountable care and population-based models shift focus from service volume to population health outcomes, encouraging preventive strategies, coordinated chronic disease management, and cost containment. Value in cardiovascular care is measured using a comprehensive framework that integrates patient-reported outcome measures (PROMs), objective clinical endpoints (e.g., mortality, readmissions, major adverse events), and economic evaluations to assess outcomes achieved relative to resources utilized.