The impact of value-based healthcare for inflammatory bowel diseases on healthcare utilization: a pilot study

Eur J Gastroenterol Hepatol. 2017 Mar;29(3):331-337. doi: 10.1097/MEG.0000000000000782.


Background and objectives: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring.

Methods: IBD patients treated within the VBHC program were identified in an administrative claims database from a commercial insurer allowing comparisons to matched controls. Only patients for whom data were available the year before and after starting the program were included. Healthcare utilization including visits, hospitalizations, laboratory and imaging tests, and medications were compared between groups.

Results: In total, 60 IBD patients treated at the VBHC Center were identified and were matched to 177 controls. Significantly fewer upper endoscopies were performed (-10%, P=0.012), and numerically fewer surgeries (-25%, P=0.49), hospitalizations (-28%, 0=0.71), emergency department visits (-37%, P=0.44), and imaging studies (-25 to -86%) were observed. In addition, 65% fewer patients (P=0.16) used steroids long term. IBD-related costs were 16% ($771) lower than expected (P=0.24).

Conclusion: These are the first results of a successfully implemented VBHC program for IBD. Encouraging trends toward fewer emergency department visits, hospitalizations, and long-term corticosteroid use were observed. These results will need to be confirmed in a larger sample with more follow-up.

MeSH terms

  • Academic Medical Centers
  • Administrative Claims, Healthcare
  • Adrenal Cortex Hormones / administration & dosage
  • Cost Savings
  • Cost-Benefit Analysis
  • Databases, Factual
  • Drug Administration Schedule
  • Drug Costs
  • Emergency Service, Hospital / statistics & numerical data
  • Health Resources / economics
  • Health Resources / statistics & numerical data*
  • Health Resources / trends
  • Hospital Costs
  • Hospitalization
  • Humans
  • Inflammatory Bowel Diseases / diagnosis
  • Inflammatory Bowel Diseases / economics
  • Inflammatory Bowel Diseases / therapy*
  • Los Angeles
  • Pilot Projects
  • Process Assessment, Health Care* / economics
  • Process Assessment, Health Care* / trends
  • Program Evaluation
  • Time Factors
  • Treatment Outcome
  • Value-Based Health Insurance* / economics
  • Value-Based Purchasing* / economics
  • Value-Based Purchasing* / trends


  • Adrenal Cortex Hormones