2018 John J. Conley Ethics and Philosophy Lecture

Michael E. Porter, PhD

In Michael Porter’s lecture, “Value-Based Health Care Delivery: The Strategic Agenda,” he provides an overview of urgency for change, the definition of value, and how surgeons can play a leadership role in the transformation of the health care sector. Prof. Porter starts with highlighting that a transformation in health care delivery—one based on value for patients—is underway and underscores the implications of this transformation for surgeons. He describes why having clarity on a single unifying goal is urgent and how the notion of value unites all stakeholders, including patients, families, payers, and employers.

Prof. Porter illustrates how health care spending is rising at an exponential rate and urges surgeons that while they continue innovating in the medical sciences, they also need to innovate in health management and in organizing the delivery of care. Providing examples, he demonstrates how surgeons are a major component of this transformation and how the current system undervalues their contributions. He outlines six key principles of creating a value-based health care delivery system—organizing care around patient conditions or population segments, measuring outcomes and costs, moving to value-based payment systems, integrating care across multiple sites, and across geography, and building innovative information technology systems to support these strategic steps.  The lecture highlights the key ideas of value-based health care, and how the strategic playbook of this concept can be applied in real world setting.

The lecture also marked the beginning of the THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Project. This initiative is a collaboration between the research faculty at Harvard Business School and the American College of Surgeons and aims to measure both outcomes and cost at leading centers of excellence, initially focusing on 3 conditions (colon cancer, breast cancer, and obesity with bariatric surgery). Each provider site is identifying opportunities to improve care while lowering cost and working to better measure the value provided to patients under value-based payments.