Transparency in Coverage Rule – The Transparency in Coverage final rule sets requirements for all insurance carriers and group health plans to disclose cost-sharing data on request to beneficiaries, members, enrollees, and their authorized representatives. Specifically, it:
- Requires insurers to make such data available online and in paper format so requesters can guess out-of-pocket expenses and shop for services and items as needed.
- Requires plans to disclose their out-of-network allowed charges, in-network negotiated rates, drug pricing data, and other information in a machine-readable format.
- Amends program rules about medical loss ratio, empowering issuers who offer individual or group coverage to obtain credit for enrollees doing their own shopping for higher-value, lower-cost healthcare providers.
Price transparency rules like the Transparency in Coverage final rule are increasing pressure for providers to adopt value-based contracts because they require providers to disclose the prices they charge for healthcare services. This increased price transparency can make it more difficult for providers to maintain high prices for services, as consumers may be more likely to compare prices and choose lower-cost options.
As a result, providers may be motivated to shift to value-based contracts, which can provide a more stable revenue stream and align incentives with value. Under value-based contracts, providers are typically paid based on the value they deliver to patients rather than the volume of services they provide.
This can incentivize providers to focus on the quality of care and cost-effectiveness, rather than simply providing more services to generate revenue. By shifting to value-based contracts, providers may be able to better manage their costs and maintain their profitability in the face of increased price transparency.
What is a value-based approach to health?
What strategies are used to promote value-based care? – Payers and federal regulators can use a variety of incentives and mechanisms to motivate health care providers and organizations to deliver higher-quality, cost-effective care. Financial incentives.
Upside and downside risk. Some models have upside-only risk — providers stand to gain revenue if they exceed expectations on quality, cost, or equity targets. Other programs also include downside risk — providers lose revenue if they fail to meet these goals. Some evidence suggests that models that include both upside and downside risk, also known as two-sided risk, may generate better outcomes, such as fewer hospitalizations. Although risk of revenue loss can be a strong motivator, two-sided risk may prevent risk-averse providers from joining a value-based program in the first place. Prospective versus retrospective payments. In the U.S., most health care is paid for on a retrospective, fee-for-service basis, with providers reimbursed for services they’ve already delivered. Prospective payments, on the other hand, are given upfront to providers to manage care for a defined set of patients and procedures — and, in some cases, for a defined period. This type of payment is commonly referred to as “capitation.” Prospective payments may create a stronger financial incentive for providers to lower the cost of care so they can retain more revenue. Percentage of providers’ revenue tied to value-based payments. Evidence suggests providers are more motivated to change how they deliver care when more of their revenue comes from value-based payments, since more is at stake. When more revenue is tied to value-based payment, there’s also less administrative burden for providers that often receive payment from a variety of sources. Timing, size, and delivery of incentives. Providers are more likely to be motivated by financial incentives that are offered to them directly and given without delay. Incentives should be clearly linked to specific outcomes and large enough to be meaningful.
Nonfinancial incentives. Nonfinancial incentives also can encourage clinicians, health systems, and payers to improve quality, safety, and cost outcomes. For example, participation in value-based care models that offer greater flexibility to deliver the right care at the right time can contribute to providers’ sense of purpose, mission, and professionalism.
And, when health care entities perform well in value-based care, it can elevate their reputation as a provider of high-quality, affordable care. Measurement. How health and hospital systems and individual clinicians are paid can depend on how well they perform on measures of quality and safety, such as death rates or patients’ ability to access timely care, as well as measures of equity and cost.
To gauge providers’ performance at one moment or over time, public and private sector health care entities and regulators collect and analyze data on specific measures. Accreditation. CMS can require health care entities to adhere to the quality and safety standards set by certain third parties to participate in the Medicare or Medicaid programs.
- For example, Joint Commission accreditation is required for hospitals and health systems to receive Medicare or Medicaid reimbursement.
- Government agencies can create rules that encourage providers to meet specific standards of quality, equity, and cost-effective care.
- For example, CMS sets rules requiring managed care plans to include a certain number of providers in their network so Medicaid beneficiaries can access services.
Public reporting. Publicizing how well health care providers and health plans perform on certain measures can drive them to improve performance. For example, people can search Medicare.gov to find out the rate of complications for hip and knee replacement surgeries at a hospital.
What is value-based healthcare pay for performance?
Pay-for-performance and value-based purchasing are terms used to describe healthcare payment systems that reward doctors, hospitals, and other healthcare providers for their efficiency, rather than the total volume of services they provide. These value-based systems are also known as alternative payment models, or APMs.
- Efficiency is usually defined as providing higher quality for a lower cost, with improved patient outcomes, high patient satisfaction, and reduced per-capita medical spending,
- This article will explain how value-based payment systems work, the types of value-based payment systems that are used in American healthcare, the challenges these systems face, and how well-designed value-based payment systems can reduce costs and improve patient outcomes.
Hero Images / Getty Images Value-based payment models have played a significant role in the healthcare reform debate that’s been ongoing in the U.S. throughout the 21st century. The federal government has spent the last several years implementing a variety of value-based payment programs in the Medicare program.
- Medicare accounts for more than a fifth of all medical expenditures in the U.S., and private health insurance companies often follow Medicare’s lead when it comes to innovations.
- The Medicaid program, which is jointly run by the federal and state governments, has also been shifting to value-based payment models under Medicaid managed care programs, in which the state contracts with private health insurance companies that manage the payment of medical claims for enrollees.
As of 2019, 38.2% of healthcare payments in the United States—including 50% of Medicare Advantage payments—were made under alternative payment models. Some value-based payment models have shown success in reducing overall spending on health care while improving or maintaining outcomes and patient satisfaction, but results for others have been mixed.
What does the acronym VBHC stand for?
Value-Based HealthCare (VBHC)
What is outcome based contract?
Cross-sector partnering for service delivery – Traditional models of contracting out public services have generally focused on the activities service users will participate in. This payment model is called fee-for-service (FFS), A particular service is specified, and providers are paid to deliver that service.
However, public services ultimately exist to deliver outcomes for service users – that is, positive changes in the life of the individual. Outcomes-based approaches to public services have long been advocated in academic literature, and in recent years they have increasingly been applied in practice.
Bovaird and Davis (2011) identify five main ways in which outcomes are currently incorporated into public services, based on evidence from the United Kingdom:
- Outcomes-Based Accountability – When assessing public bodies, outcomes can be used to define responsibilities and what counts as success.
- Outcomes-Based Commissioning – When assessing need and designing public services, outcomes can be used to agree priorities with stakeholders and design relevant interventions.
- Outcomes-Based Procurement – When selecting which providers should be contracted to deliver services, outcomes can be used in the decision-making process.
- Outcomes-Based Contracting – When implementing services, outcomes can be used to frame the relationship between contracting organisations and service providers, through an outcomes-based contract.
- Outcomes-Based Delivery – When delivering a service, outcomes may influence the way in which providers shape their activities.
These different categories all reflect a broader outcomes orientation in the contracting out of public services. Instead of focusing on individual services, an outcomes orientation focuses on what ought to change for service users and structures service provision accordingly,
For example, in the domain of employment, instead of focusing on particular skills training or job search services, an outcomes approach would focus on the long-term employment of a job-seeker as the ultimate desired goal of a service. This might mean a much broader range of services are considered to support users into employment.
Outcomes-based contracting ties this outcomes orientation directly into the incentive structure of public service contracting. In an outcomes-based contract, payment is wholly or partly dependent on outcomes being achieved, Service providers are therefore directly incentivised to deliver outcomes with service users.
What is value based approach theory?
From Wikipedia, the free encyclopedia In ethics and the social sciences, value theory involves various approaches that examine how, why, and to what degree humans value things and whether the object or subject of valuing is a person, idea, object, or anything else.
Within philosophy, it is also known as ethics or axiology, Traditionally, philosophical investigations in value theory have sought to understand the concept of ” the good “. Today, some work in value theory has trended more towards empirical sciences, recording what people do value and attempting to understand why they value it in the context of psychology, sociology, and economics,
In ecological economics, value theory is separated into two types: donor-type value and receiver-type value. Ecological economists tend to believe that ‘real wealth’ needs an accrual-determined value as a measure of what things were needed to make an item or generate a service ( H.T.
- Odum, Environmental Accounting: Emergy and environmental decision-making, 1996).
- In other fields, theories posit the importance of values as an analytical independent variable (including those put forward by Max Weber, Émile Durkheim, Talcott Parsons, and Jürgen Habermas ).
- Classical examples of sociological traditions which deny or downplay the question of values are institutionalism, historical materialism (including Marxism ), behaviorism, pragmatic -oriented theories, postmodern philosophy and various Objectivist -oriented theories.
At the general level, there is a difference between moral and natural goods. Moral goods are those that have to do with the conduct of persons, usually leading to praise or blame. Natural goods, on the other hand, have to do with objects, not persons. For example, the statement “Mary is a good person” uses ‘good’ very differently than in the statement “That is good food”.
What is value based performance management?
Value-based management (VBM) is a mindset that views the value of an organization as the ultimate measure of success. Successful VBM depends on highly effective strategic planning, supported by a performance management system that drives the value mindset into the organization’s overall culture.
What is VB in medical terms?
Bacterial vaginosis – Symptoms and causes – Mayo Clinic.
What does lof mean in medical terms?
LOF: Loss of fluid.
What does Lom mean in medical terms?
L leukocytes lumbar vertebrae (L1 to L5) L&D labor and delivery LA left atrium lymphadenopathy local anesthetic LAAM L-alpha- acetylmethadol Lab laboratory (in health care, usually referring to clinical laboratory ) LABA long-acting beta agonist LABBB left anterior bundle branch block Lac laceration lactate LAD left anterior descending (a coronary artery ) leukocyte adhesion deficiency left axis deviation (see electrocardiogram ) lymphadenopathy LAE left atrial enlargement LAH left anterior hemiblock LAHB left anterior hemiblock Lam laminectomy LAN lymphadenopathy LAP leukocyte alkaline phosphatase Lap laparotomy Lap appy laparoscopic appendectomy LAR low anterior resection LARP left → anterior, right → posterior (path of the vagi as they wander from thorax to abdomen) LAS lymphadenopathy syndrome Lat lateral lb LB pound or pounds (mass) LBBB left bundle branch block LBO large bowel obstruction LBP low back pain LBW low birth weight LCA left coronary artery LCHAD long-chain 3-hydroxyacyl-coenzyme A dehydrogenase LCIS lobular carcinoma in situ LCM lymphocytic meningitis LCMV lymphocytic choriomeningitis virus LCP Liverpool Care Pathway for the Dying Patient LCPD Legg–Calvé–Perthes disease LCV leukocytoclastic vasculitis LCX left circumflex artery L&D labor and delivery LDH lactate dehydrogenase LDL low-density lipoprotein LDL-C low-density lipoprotein cholesterol L-DOPA levo-dihydroxyphenylalanine LEC lupus erythematosus cell LEEP loop electrical excision procedure LES lower esophageal sphincter lupus erythematosus systemicus LE lupus erythematosus lower extremity ( human leg ) leu leukocytes LFT liver function test LGA large for gestational age LGL Lown–Ganong–Levine syndrome LGM lymphogranulomatosis maligna LGSIL low-grade squamous intraepithelial lesion LGV lymphogranuloma venereum LH luteinizing hormone lightheadedness LHC left heart catheterization LHRH luteinizing hormone–releasing hormone Lig ligament LIH left inguinal hernia LLD leg length discrepancy LLE left lower extremity LLETZ large loop excision of the transformation zone LLL left lower lobe LLQ left lower quadrant LM left main LMA left mentoanterior ( fetal position ) laryngeal mask airway LMCA left main coronary artery LMD local medical doctor LMP last menstrual period —first day of the menstrual period low malignant potential LMWH low-molecular-weight heparin LN lymph node Logical Observation Identifiers Names and Codes (LOINC) LND lymph node dissection LNG levonorgestrel LNI lymph node involvement LOA left occipitoanterior ( fetal position ) level of activity lysis of adhesions Loss of Appetite LOC loss of consciousness level of consciousness (e.g., “altered LOC from head trauma”) LOF leakage of fluid LOH loss of heterozygosity LOI loss of imprinting LOL little old lady (often LOL in NAD—see House of God ) lymph-obligatory load LOM limitation of motion LOP left occiput posterior ( fetal position ) LORTA loss of resistance to air (in anesthesiology; when placing epidural, LORTA indicates entrance of needle to epidural space ) LOS length of stay Lot lotion LOT left occiput transverse ( fetal position ) Lp lipoprotein LP lumbar puncture LPH left posterior hemiblock (see heart block ) LPL lipoprotein lipase LPP lichen planopilaris LQTS long QT syndrome L/S lecithin -to- sphingomyelin ratio LS lichen sclerosus Lynch syndrome LSA lichen sclerosis et atrophicus LSB left sternal border LSCS Lower segment Caesarean section LSCTA lung sounds clear to auscultation LSIL low-grade squamous intraepithelial lesion LST laterally spreading tumor LR lactated Ringer’s solution LRINEC Laboratory Risk Indicator for Necrotizing Soft Tissue Infections Score LRTI lower respiratory tract infection LT heat-labile enterotoxin LTAC long-term acute care LTCS low transverse cesarean section LUL left upper lobe (of lung ) LUQ left upper quadrant (of abdomen) LUS lower uterine segment LUTS lower urinary tract symptoms LV left ventricle LVAD left ventricular assist device LVEDP left ventricular end diastolic pressure LVEF left ventricular ejection fraction LVF left ventricular failure LVH left ventricular hypertrophy LVOT left ventricular outflow tract LVNC left ventricular noncompaction (see noncompaction cardiomyopathy ) LVP Large volume paracentesis LWBS left without being seen Lx of ch laxative of choice Ly lymphocytes lytes electrolytes
What are the three types of contracts explain?
Combining Different Types of Contracts – Sellers may combine different types of contracts to create one that hits all the high notes of their business exchange. Some business exchanges include a range of products and services, such as labor and equipment.
In such cases, the contract needs to outline any applicable terms and agreements from more than one type of contract to cover all parts of the transaction, such as a fixed-price contract for the labor and a cost-plus contract for the equipment. Understanding the different types of contracts and selecting the right one for the project is an important part of business transactions.
It’s often a good idea to work with a contract lawyer to make sure the contract holds up in court. As a rule of thumb, fixed-price contracts present less risk to buyers, while cost-plus contracts pose more risk to buyers. Meanwhile, time and materials contracts offer a more balanced risk for both buyers and sellers.
What is EPC vs DB contract?
Active Participant: – An EPC project results in a turnkey facility. The EPC contractor heads the working of the project facility. A design-build contract finishes off comparatively to configuration offer form contracts, with the proprietor and its development director or fashioner playing a functioning job in punching out the office.
- The design-builder is held by the proprietor from the get-go in the life of the undertaking and, now and again, before the structure has been created by any means.
- Design-build is used to limit dangers for the venture proprietor and to decrease the conveyance plan by covering the structure stage and development period of an undertaking.”DB with its single point duty conveys the clearest legally binding solutions for the customers in light of the fact that the DB contractual worker will be in charge of the majority of the work on the undertaking, paying little heed to the idea of the blame.” It answers the client’s wishes for a single point of responsibility in an attempt to reduce risks and overall costs.
These contractors are usually handed little more than performance requirements varying, whereas most design-build configuration assemble contracts give probably some plan detail in the connecting reports. EPC equivalent of the “structure help” or “quick track” plan construct forms is not available.By and by, this mirrors the proprietor’s increasingly negligible contribution in the EPC configuration process.
What are examples of performance based contracts?
Performance-Based Vs Method-Based Contracts – Performance-based contracts are different than traditional method-based contracts where the techniques, technologies, materials, and material quantities are specified by the client. In traditional contracts, payment to the contractor is based on what was used, how many hours were worked, and other similar factors.
Instead, performance-based contracts allow the client to set performance indicators the contractor must meet when completing services. An example would be a road maintenance contractor that is paid for the results of his work. If a contractor is tasked to fill potholes, their contract might be based on performance.
If no potholes remain, they have fully met the performance expectations and payment will be made as per the contract. If they fail to meet the performance indicators or to offer solutions to fix the incomplete portion, their payment will be affected and a series of penalties will be levied.
What is an example of value based?
When is Value-Based Pricing Used – Value-based pricing is used when the perceived value of the product is high. The strategy tends to involve products that possess a certain level of prestige in ownership or are completely unique. Designer apparel companies are well-known for using value-based pricing.
- While a designer shirt may cost nominally more than a non-designer shirt to produce, the status carried by the designer brand increases the perceived value of the shirt.
- Many companies capitalize on such perception, increasing their margins greatly, while minimally reducing sales volume.
- A similar strategy may also be used when the purchasing decision is emotionally driven.
For example, while a famous painting may sell for millions of dollars at an auction, the cost of creating that painting is meaningless relative to the sale price. The value and price are being derived from the prestige of the artist, as well as other emotional aspects that the buyer may connect with.
What is value based planning?
Value-based planning integrates the impact strategies have on shareholder value into strategic decision making. To do this, the value that arises from the pursuit of a strategic option for a business is calculated.
What is the approach of value-based management?
Value-based management (VBM) is a mindset that views the value of an organization as the ultimate measure of success. Successful VBM depends on highly effective strategic planning, supported by a performance management system that drives the value mindset into the organization’s overall culture.
What is value-based approach in ethics?
The value-based approach identifies the less formal aspects of ethics management including inter alia communicating moral expectations with employees, visible punishing offenders, ethics training, and appraising ethics performance of employees by making it a stand-alone key performance area.
What is value in health Elsevier?
Guide for Authors Value in Health is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions.
The Society’s flagship journal, Value in Health is a monthly publication that circulates to 10,000 readers around the world. For the past few years, Value in Health has demonstrated significant growth in the journal?s impact factor. The journal’s current impact factor is 5.725 and the 5-year impact factor score is 6.932.
The journal is now rated 4th of 88 journals in healthcare sciences and services, 9th of 108 journals in health policy and services, and 24th of 376 journals in economics (social science). The journal has also witnessed more than a 70% increase in submissions over the past 5 years.
As a result, the editors now find it necessary to reject many more papers without peer review, including ones that may be suitable for publication in other leading journals. In 2020, the journal’s overall rejection rate was nearly 85%. Although we recognize that authors never want to hear that their papers are rejected, we also know that they value a fast response time.
That said, the editors strive to return decisions on papers that are not sent out for an external peer review within 2 weeks. Where We’re Indexed
- Index Medicus/MEDLINE®
- Current Contents/Social & Behavioral Sciences
- SciSearch/SCI Expanded
- Social Sciences Citation Index
- International Pharmaceutical Abstracts
- Embase/Excerpta Medica
- PsycINFO/Psychological Abstracts
- Journal Citation Reports/Science Edition (Clarivate Analytics)
- The Guide for Authors for Value in Health can be found
- I. EDITORIAL SCOPE
- About the Journal
As the official journal of ISPOR, Value in Health provides a forum for researchers, healthcare decision makers, and policy makers to apply health economics and outcomes research into healthcare decisions. The goal of Value in Health is to advance scholarly and public dialogue about the assessment of value in health and healthcare.
Increasingly, healthcare decision makers and policy makers are seeking outcomes research information (ie, comparative treatment effectiveness, economic costs and benefits, and patient-reported outcomes) that can guide them in healthcare resource allocation and in evaluating alternative treatments and health services interventions.
Value in Health publishes original research articles in the areas of economic evaluation (including drugs and other medical technologies), outcomes research (“real-world” treatment effectiveness and patient-reported outcomes research), and conceptual, methodological, and health policy articles.
All research papers accepted for publication must be conducted in a rigorous manner and must reflect valid and reliable theory and methods. Empirical analyses and conceptual models must reflect ethical research practices and provide valuable information for healthcare decision makers and the research community as a whole.
The journal uses the peer-review process to ensure rigorous and transparent use of statistical methods. Value in Health also requires that papers reporting modeling results include sensitivity analysis of key and influential model parameters. ISPOR Journals: Where to Publish? In 2012, ISPOR launched a companion journal to Value in Health called Value in Health Regional Issues,
- The mission of Value in Health Regional Issues is to provide a forum for the advancement and dissemination of research in health economics and the health-related outcomes of populations in 3 specific regions: Asia, Latin America, and Central and Eastern Europe, Western Asia, and Africa.
- A major objective of the new journal was to provide an additional publication outlet for researchers in these regions.
However, Value in Health Regional Issues has grown in stature over the years and is now indexed in MEDLINE and the Web of Science. Therefore, the distinction between Value in Health and Value in Health Regional Issues is less clear than initially intended.
- Thus, potential authors from the regions covered by Value in Health Regional Issues may be wondering which journal is most appropriate for submission of their papers.
- The main distinction between the two journals is not in the methodological quality of papers they publish, but rather in their focus.
- Considering the diverse readership of Value in Health, papers submitted to this journal should have relevance beyond the country where the research was conducted.
The clearest example of this would be a paper discussing a new methodological approach that could be applied in a number of settings, or the ISPOR Good Research Practices Reports, which provide statements on current international methodological standards.
Value in Health is less interested in in publishing country applications of economic models that have been published previously, or country adaptations of quality-of-life instruments, unless there are some broader insights from these adaptations. On the other hand with its particular focus on challenges and opportunities in countries with developing economies or healthcare systems, Value in Health Regional Issues may have higher interest in these papers if (1) they meet the journal’s methodological standards and (2) they provide useful insights for the region concerned.
Mission Statement The mission of Value in Health is to set a high scientific standard using editorial review and peer review, not just to screen articles, but also to foster communication within the research community-facilitating knowledge-sharing between the outcomes research community and healthcare decision makers.
- As such, the editors of Value in Health aim to enhance the validity, reliability, and transparency of health economics and outcomes research and its real-world applicability.
- Editorial Scope In keeping with its broad mission, Value in Health welcomes papers that make substantial contributions to the existing literature by providing new evidence or ideas that extend the current knowledge base.
As such, manuscripts should describe the unique contribution of the article and place the current paper in context with the existing literature. Value in Health does not consider papers reporting data series or data sets that do not include appropriate statistical analyses.
- For empirical papers, Value in Health might publish some of the first results of the cost-effectiveness or health outcomes gained from a new health technology, since these may be helpful for countries that have not yet evaluated the technology concerned.
- It might also publish papers exploring the impact of an innovative health policy that may be capable of application in other countries.
However, Value in Health is less interested in publishing country applications of economic models that have been published previously, or country adaptations of quality-of-life instruments, unless there are some broader insights from these adaptations.
Appropriate valuation of healthcare interventions requires multidisciplinary perspectives and assessment of economic and outcomes data. Therefore, the journal welcomes theoretical and empirical articles about health effects and health costs that strive to improve the quality and reliability of outcome evaluations of healthcare intervention-contributed not only by economists, but also by behavioralpsychologists, sociologists, clinicians, ethicists, and others.
Value in Health is particularly interested in receiving articles in the following areas: Economic Evaluations Economic evaluations that assess the costs and consequences of alternative healthcare interventions are of interest, including those involving drugs, devices, procedures, and systems of organization of healthcare.
- However, studies that only consider costs or the economic burden of disease are less likely to be accepted unless they address important methodological or policy issues.
- Patient-Reported Outcomes Many challenging empirical and theoretical problems remain in the concept and measurement of patient-reported outcomes (PRO), including health-related quality of life (QoL).
Articles presenting research on the development of measures for PRO/QoL instruments, especially innovative ways of assessing content or construct validity, are invited.
- Preference-Based Assessments
- Research on the development and use of various types of instruments to express the value of healthcare, including health “utility” assessments, discrete choice experiments/conjoint analyses, and assessments of individuals’ willingness to pay is encouraged.
- Comparative-Effectiveness Research/Health Technology Assessment
Although it is difficult to be precise about the nature of the articles in this category (see Luce et al, The Milbank Quarterly,2010;88:256-276 for one taxonomy), Value in Health welcomes articles presenting information that can assist those deciding on the efficient and equitable allocation of healthcare resources by examining the relative value of interventions.
- In some cases, relative value may be addressed by considering only clinical outcomes, although normally it will involve considering PRO/QoL measures and impacts on resource utilization.
- Articles in this category can report the results of primary research or present findings from meta analyses or systematic reviews of the existing literature.
Health Policy Analyses The journal invites articles that discuss various aspects of health policy, in particular those concerned with pricing and reimbursement issues, the adoption of new health technologies, or policies to encourage “value-based” decision making.
However, the journal’s scope does not include papers dealing with more general issues of healthcare financing, health insurance, and cost-containment measures. Policy on the Publication of Research Previously Available in the Public Domain In common with most peer-reviewed journals, Value in Health is keen to publish original material that will be highly impactful.
However, Value in Health editors are aware that, within the field of health services research and policy, some material may have been available previously as a working paper, research paper, or through publication on the host institution’s website. Value in Health does not have a firm policy to reject material that has been available previously in the public domain.
- Does the paper summarize the material from a much longer report that makes it more accessible to the readership of Value in Health and more likely to impact decision making because of the peer-reviewed publication?
- Does the paper add to the methods and/or data published in the original report, either by reporting more data or by raising different discussion points?
- In the case of a working paper or research paper, is the version submitted for peer review substantively different from the publicly posted draft version, and will the organization that published the draft paper remove the draft version and redirect individuals to the final published paper in Value in Health ?
If one or more of the above criteria are met, the paper may be considered for publication in Value in Health through our normal peer-review process. If Value in Health publishes the paper, a link from the original posting’s website should refer readers to the Value in Health publication.
- Some authors are posting their papers as “preprints,” so that they can be made available in the public domain while they are being peer-reviewed.
- Most publishers are aware of this process but delegate decisions on publication to each individual journal.
- There are currently different views among journal editors on whether posting papers as preprints constitutes prior publication.
Therefore, if an author is considering posting their paper on a preprint server, we strongly encourage them to contact the journal in advance. Following Good Practices for Outcomes Research Value in Health publishes Good Practices Reports that are developed by task forces appointed by the ISPOR Board of Directors.
These task force reports () provide guidance for best practices across a variety of research areas,including methods related to articles relevant to the scope of Value in Health, These include comparative-effectiveness research, economic evaluation, observational studies, patient-reported outcomes, modelling, preference-based methods, and the use of outcomes researchin decision making.
Although Value in Health does not prescribe any particular research methods, the editors strongly encourage authors to review the ISPOR Good Practices for Outcomes Research reports relating to the methods or topics covered by their paper. The reports are written by thought leaders in the various fields of research and are extensively peer reviewed by members of the Society.
Some of the task force reports address the reporting of research studies. Irrespective of the methods used in a particular study, Value in Health believes that adherence to accepted standards of reporting is important. Therefore, if your paper reports an economic evaluation,we recommend that you follow the and submit a completed CHEERS 2022 checklist as supplementary material with your submission.
If your analysis is based on a model, we recommend that you follow the guidance in the ISPOR-SMDM Task Force report on model transparency and validation. Other reporting standards of particular relevance to authors of papers in Value in Health are the PRISMA 2020 guidelines for the reporting of systematic reviews and the CONSORT guidelines for reporting the results of studies assessing health-related quality of life/patient-reported outcomes.
- In addition, the editors encourage authors to follow recent guidance(“Updated Guidance on the Reporting of Race and Ethnicity in Medical and Science Journals”) published in JAMA for reporting race and ethnicity in medical journals.
- Article Categories Value in Health considers articles in the following categories, which comprise the sections of the journal.
When submitting a manuscript through our online system, authors should indicate the appropriate category under which they wish their paper to be considered. All submissions will be considered for peer review prior to publication, with the exception of Editorials, Commentaries, and Letters to the Editor, which will be reviewed internally by the editors.
|Article Type||Description||WordLimit*||Limit No.Figures/Tables**|
|Original Research||These papers report the findings of original research and may contain the results of empirical analysis, instrument development, or policy analysis.||4000||6|
|Methodological Articles||As the name implies, these papers deal with methodological issues in any of the topicareas within the scope of the journal. They can include data if these are required toillustrate the importance of particular methodological points.||3500||6|
|Policy Perspectives||These papers discuss important health policy topics within the scope of the journal. They may reflect conceptual pieces or reviews of the literature.||3000||4|
|Systematic LiteratureReviews||These papers review empirical studies consistent with the methods of systematicreview proposed by the Cochrane Collaboration. However, they need not be confined to reviews of randomized controlled trials and can include reviews of observational studies, economic evaluations, outcomes research studies, and preference-based assessments.||4000||6|
|Brief Reports||These are empirical analyses with a more narrow focus than original research articles and generally a single aim.||2500||2|
|Commentaries||These brief papers present a particular perspective on a timely or controversial topic. They do not necessarily need to be based on original research or reviews of theliterature and can be based on opinion, providing the points made are transparent andwell-argued. While commentaries are typically invited contributions, the editors willconsider unsolicited submissions.||2000||1|
|Editorials||Editorials are commissioned by the editorial team and often accompany a paperpublished in the same issue.||1200||1|
|Letters to the Editor||Customarily, letters refer to content published in the journal within the past 6 months. Authors of the article to which the letter refers will be given the opportunity to reply, and if a response is issued, both the letter and the reply will be published in the same issue of the journal.||1500||1|
The manuscript word limit excludes the abstract, references, figure legends, tables, and appendices/supplemental materials.**The maximum number of graphic elements reflects a combined total of figures (including figure parts) and tables. II. MANUSCRIPT SPECIFICATIONS AND SUBMISSION Value in Health uses a web-based submission system.
To submit a manuscript, please create an account and log on here:, For assistance, authors may contact the Value in Health editorial office at, Author Anonymity It is the policy of Value in Health that peer review of submitted manuscripts is double blinded (ie, the reviewers do not know the namesof the authors of manuscripts and the authors do not know the names of the reviewers).
As such, the journal requires that all identifying information (author names, acknowledgements, etc) be removed from the manuscript components (including files names) and strictly limited to the cover letter and unblinded title page (which are not accessible to peer reviewers).
Manuscript Formatting Manuscripts must be written in English, typed in 12-point Times New Roman font, double-spaced, using an 81/2 x 11-inch page format with 1-inch margins on all sides. Manuscripts must be submitted as editable files (preferably as Word documents) and contain minimal formatting (ie, no line numbers, no watermarks, no justification, underlining, indenting, etc).
The document should not cross-reference or use hyperlinks to connect to Figures, Tables, or references within the file. Authors should consult the AMA Manual of Style: A Guide forAuthors and Editors (10th ed) or the Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals (ICMJE Recommendations) for specific style issues not addressed here.
|Font||12-point, Times New Roman|
|Line Spacing||Double-spaced throughout|
|Margins||One inch (2.5 cm) on all sides|
|Page size||Letter (81/2 x 11 inches)|
|Page numbering||Bottom of page, centered (starting with abstract page)|
|Heading style||First level: bold, second level: bold italics|
|Title||The full title and subtitle of the article (no more than 25 words)|
|Description/Interest to Readers||A brief description of the article, indicating why the paper would be ofparticular interest to the journal’s readership|
|Statement of Proprietary Data||Statement indicating whether the data, models, or methodology usedin the research are proprietary|
|Funding/Support||All financial and material support for the research must be disclosed.Include the complete names of the funding organization(s) and grantnumbers, where applicable|
|Role of Sponsor||Statement that the publication of study results was not contingent onthe sponsor?s approval or censorship of the manuscript|
|Contact Information for the Corresponding Author||Full name (first, middle, last) and degree; department; institution;mailing address; email; and phone number|
|Manuscript title and subtitle, as appropriate||Concise title of the manuscript; no more than 25 words; in title case (not all caps)||Clinical Guidelines: A NICE Way to Introduce Cost-Effectiveness Considerations|
|Full names, degrees, and affiliation for each author (unblinded title page only)||List the first name, middle initial (if applicable), surname, highest academic degree(s) (excluding certifications and fellowship designations), affiliation (department and institution), and city/province, state, and country for each author||John D. Doe, Jr, MDDepartment of MedicineUniversity of YorkHelsington, YorkUnited KingdomSusan T. Smith, MD, MPHDepartment of Health PolicyUniversity of ChicagoChicago, IL USA|
|Contact information for corresponding author (unblinded title page only)||Provide the full name, degrees, mailing and email addresses, and phone number of the corresponding author (the person to whom all correspondence regarding the manuscript will be directed)||Thomas J. Wright, III, PhDDepartment of EconomicsPrinceton UniversityRobertson HallPrinceton, NJ, [email protected] Phone: (609) 123-4567|
|Precis||25-word summary of the article (avoid simply restating the title)||Precis: Current Medicaid policies that restrict hepatitis C treatment to patients with advanced disease are more costly and less effective than unrestricted, full-access strategies.|
|Word count (see limits for particular article types above under )||Total number of words (excluding abstract, references, figure legends, tables, appendices)||Word Count: 3250|
|Number of pages||Total number of pages (including figures, tables, appendices, etc) of the article||Number of Pages: 25|
|Number of figures (see limits for particular article types above under )||Total number of figures (including figure parts ) in the main article (figures in appendices should be counted separately)||Number of Figures: 4|
|Number of tables (see limits for particular article types above under )||Total number of tables in the main article (tables in appendices should be counted separately)||Number of Tables: 2|
|Appendices/supplemental materials||Include inclusive number of pages, figures, and tables for any supplemental materials||Appendix: Pages: 6Figures: 2 Tables: 0|
|Author Contributions||Provide last name of author (in order listed on the title page) for each category as per the information provided in Section D on the author’s completed,||Author Contributions: Concept and design : Neumann, Basu,Ollendorf, Cohen Acquisition of data : Neumann, Podolsky Analysis and interpretation of data : Neumann, Podolsky, OllendorfD rafting of the manuscript : Neumann,Podolsky, Basu, Cohen Critical revision of the paper for important intellectual content : Neumann, Basu, Ollendorf, Cohen Obtaining funding : Cohen Administrative, technical, or logistic support : Neumann Supervision : Neumann, Ollendorf|
|Conflict of Interest Disclosures||This statement must exactly match the informationprovided in Section 6 of each author’s, Please list each author’s disclosures in the same order they’re listed in the author byline.||Conflict of Interest Disclosures: Drs Neumann, Ollendorf, and Cohen, and Ms Podolsky reported receiving grants from RA Capital during the conduct of the study. Dr Neumann reported serving as an advisory board member for the Congressional Budget Office, Biogen, the PhRMA Foundation, and Novartis outside the submitted work. Ms Podolsky reported receiving grants from the PhRMA Foundation and the NationalPharmaceutical Council outside the submitted work. Dr Basu reported receiving consulting fees from Salutis Consulting LLC outside the submitted work. Dr Ollendorfreported receiving personal fees from EMD Serono, Amgen, the Analysis Group outsidethe submitted work. Dr Cohen reported receiving personal fees from Biogen, IQVIA, Novartis, and Sanofi outside the submitted work. Dr Basu is an editor for Value in Health and had no role in the peer-review process of this article.|
|Funding/Support||Include a brief statement indicating all sources of financial support received for the manuscript. Include the complete names of the funding organization(s) and grant numbers, where applicable. If no funding was received, this should be noted on the title page.||Funding/Support: This work was supported by grants 123-456 from the XYZ Foundation. Funding/Support: The authors received no financial support for this research.|
|Role of the Funder/Sponsor||Include a statement that describes the funder’s role in the submitted work to appear with the published article.||Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.|
|Acknowledgment||Include a statement to acknowledge the assistance of anyone who contributed to the paper (ie, editorial or writing assistance, statistical review, special research assistance, etc), but does not meet the criteria for authorship.||Acknowledgment: Professional medical writing and editorial assistance was provided by Adam Doble of Foxymed (Paris, France).|
3. Manuscript Components All manuscript submissions must contain the following components (see table below). Start each component on a new page.
|Abstract||• Structured (objectives, methods, results,and conclusions)• 250 words||All submissions (except Letters to the Editor and Editorials) must include an abstract that summarizes the work reported in the manuscript. Commentaries should include a brief, nonstructured abstract/summary.|
|HighlightsAuthors should identify 2–3 “Highlights” thatillustrate the paper’s contribution to the field.||• 2–3 brief summary statements• 75-word limit for each highlight statement||Authors should identify 2–3 “Highlights” that illustrate the paper’s contribution to the field. These bulleted statements should address:i. What is already known about the topic?ii. What does the paper add to existing knowledge? iii. What insights does the paper provide for informing healthcare-related decision making?|
|Body of article||• Introduction• Methods• Results• Conclusions • Discussion||The body of the manuscript should be divided into sections that facilitate reading and comprehension of the material, using section headers (first, second,third, etc) as appropriate. Avoid use of footnotes.|
|References||• Cite in text using superscript Arabic numerals 1–4,22,28 • Reference list should be numbered consecutively in order cited in the text • Use AMA style for reference format||Citing unpublished or non-peer-reviewed work such as abstracts and presented papers is discouraged. Personal communications may be indicated in the text as long as written acknowledgment from the authors of the communications accompanies the manuscript. If there are 6 or more authors, use only the names of the first 3, followed by et al. The 4 most common types of references are illustrated below:|
|Journal article||Vassall A, Mangham-Jefferies L, Gomez GB, Pitt C, Foster N. Incorporating demand and supply constraints into economic evaluations in low income and middle-income countries. Health Econ 2016;25(Suppl 1):95-115.|
|Journal article with 6 or more authors||Husereau D, Drummond M, Augustovski F, et al. Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022)Explanation and Elaboration: A report of the ISPOR CHEERS II Good Practices Task Force. Value Health,2022;25(1):10–31.,|
|Book||Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the Economic Evaluation of Health Care Programmes (4th ed). New York: Oxford University Press, 2015.|
|Book chapter||Schulman KA, Glick HA, Polsky D. Pharmacoeconomics: Economic Evaluation ofPharmaceuticals. In: Strom BL, Kimmel SE eds, Textbook of Pharmacoepidemiology, West Sussex, England: John Wiley & Sons, Ltd, published online May 2013. Accessed July 23, 2021|
|Website||ISPOR. ISPOR Good Practices for OutcomesResearch Index. www.ispor.org/workpaper/practices_index.asp. Accessed January 1, 2022.|
|Figures||• Numbered• Title and legends; each on separate page (not embedded or hyperlinked in text) • TIFF, JPG, EPS, and PDF file formats||Cite figures consecutively as they appear in the text using Arabic numbers (eg, Figure 1, Figure 2, Figure 3A, etc). Refer to Figures section below for more information.|
|Tables||• Numbered• Title •Double-spaced; each on separate page(not embedded or hyperlinked in text)||Tables should be provided in an editable format(preferably as a Word document), be clearly labeled, neatly organized, and easy to understand without reference to the text. Refer to Tables section below for more information.|
4. Figures Figures should each be submitted as a separate image file, not embedded or hyperlinked in the manuscript document or in a slide presentation. Cite figures consecutively as they appear in the text using Arabic numbers (eg, Figure 1, Figure 2, Figure 3A, etc).
- Each figure must be assigned a brief title (as few words as possible, and reserving abbreviations for the legend) and include a legend.
- The corresponding legend should be double-spaced on a separate page.
- All symbols, arrows, and abbreviations must be explained in the legend.
- If authors provide usable color figures with their accepted article, the journal will ensure (at no additional charge) that these figures will appear in color in the printed version and in the online version posted on the web (eg, ScienceDirect and other sites).
Image files should be provided in any the following formats: TIFF, JPG, PNG, EPS, and PDF at a minimum resolution of 92 DPI at a size of 3″ × 5″. High-resolution images preferred (300 DPI for figures; 1000 DPI for line art). Please be sure to delete any identifying patient information such as name, social security number, etc.
- Photographs in which a person’s face is recognizable must be accompanied by a letter of release from that person explicitly granting permission forpublication in the journal.
- For any previously published material, written permission for both print and electronic reprint rights must be obtained from the copyright holder.
For further explanation and examples of artwork preparation, see Elsevier’s Author Artwork Instructions at,5. Tables Tables must be submitted in an editable format (eg, Word or Excel). Do not embed tables within the text of the main document or include hyperlinks to the tables within the document.
- Either upload tables as separate files after the figures or include them in the main document after the reference section.
- Tables should be clearly labeled, neatly organized and easy to understand without reference to the text.
- Statistical estimates should indicate parameter estimates and, as appropriate, t ratios or standard error, statistical significance, sample size, and other relevant information.
The journal recommends avoiding color coding in tables. Instead, please use bold font, italic, or symbols to point out differences where color coding would have been used. All abbreviations must be explained in alphabetical order below each table (eg, DCE indicates discrete choice experiment; EMA, European Medicines Agency; MCDA, multiple criteria decision analysis).6.
- Supplementary Material or Supplementary Data Authors may submit appendices that describe either methods or results in more detail if these are needed for clarity of understanding by either peer reviewers or readers.
- If submitted, indicate the particular reasons for the appendix and whether you are submitting it for possible web publication or simply for peer-review purposes.
Please note supplementary materials are not edited or laid out; they are posted online in the format submitted to the journal. Be sure to remove all track changes and to upload supplementary materials in the file format you want readers to access the information online.7.
Data, Models, Methodology, and Survey Instruments All authors must agree to make their data available at the editor’s request for examination and re-analysis by referees or other persons designated by the editor. All models and methodologies must be presented in sufficient detail to be fully comprehensible to readers.
For papers analyzing preferences, Value in Health requires the submission of a copy of the survey instrument (translated into English if published in a different original language) used to generate the preference data. This is to help facilitate the review process, and the survey instrument need not appear in a final publication.
- If the authors wish the questionnaire to be published with the paper, it should be submitted through the journal’s online submission system as part of the paper.
- If the questionnaire is not intended to be published with the paper, it should be uploaded as “Supplemental File for Review” so that reviewers can view it as a supplemental appendix.
III. EDITORIAL PROCESS Peer Review For the past few years, Value in Health has demonstrated double-digit percentage increases in the journal’s impact factor (currently 5.725, 5-year score is 6.932). The journal is now rated 4th of 88 journals in health policy and sciences, 9th of 108 journals in healthcare sciences and services, and 24th of 376 journals in economics (social science).
The journal has also witnessed more than a 70% increase in submissions over the past 5 years. As a result, the editors now find it necessary to reject many more papers without peer review, including ones that may be suitable for publication in other leading journals. In 2021, the journal’s overall rejection rate was 82.3%.
Although we recognize that authors never want to hear that their papers are rejected, we also know that they value a fast response time. That said, the editors strive to return decisions on papers that are not sent out for an external peer review within 2 weeks.
- On the other hand, all manuscripts that are deemed appropriate for Value in Health after initial screening will be reviewed by at least two peer reviewers.
- The objective of the journal is to complete peer review and reach an editorial decision within 6 to 8 weeks of submission, at which time the corresponding author will receive written notification, including anonymous feedback from the reviewers.
ISPOR journals expect the highest ethical standards from their authors, reviewers, and editors when conducting research, submitting papers, and throughout the entire peer review process. Both Value in Health and Value in Health Regional Issues subscribe to the Committee on Publishing Ethics (COPE) and supports COPE Ethical Guidelines for Peer Reviewers.
- IV. PUBLISHING PROCESS Proofs Proofs will be sent electronically to the authors to be checked carefully for printer’s errors.
- Substantive changes or additions to the edited manuscript are not allowed at this stage.
- Any changes to authorship (additions, deletions, reorder, etc), disclosure/funding statements, author contributions, or substantial changes in the data or results require reviewand approval by the Editors.
Corrected proofs must be returned to the publisher within 48 hours. Offprints The corresponding author, at no cost, will be provided with a PDF file of the article via email. For an extra charge, paper offprints can be ordered via the offprint order form which is sent once the article is accepted for publication.
- V. PUBLISHING POLICIES AND DISCLOSURES
- Ethics in Publishing
- For information on Ethics in Publishing and Ethical guidelines for journal publication, see and,
The recommended number of authors on a paper should not exceed 10. However, Value in Health is aware that sometimes a submitted paper may have a large number of authors, in which case authorship may be assigned to a group rather than to individuals. The Editors reserve the right to seek clarification from the corresponding author if a paper has more than 10 authors, or has a large number of authors in relation to the research reported in the paper.
- Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND
- Drafting the work or revising it critically for important intellectual content; AND
- Final approval of the version to be published; AND
- Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
- Authors can read the full set of recommendations at,
- Submission Declaration
- Submission of an article implies that the work described has not been published previously (except in the form of an abstract or as part of a published lecture or academic thesis), that it is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere (either in whole or in part, in print or electronic form, in English or in any other language, etc) without the written consent of the copyright holder.
- Open Access
In recent years, the importance to authors of open access has been increased by the policies of major research funders in many countries, requiring that the publications arising from the work they fund should be freely available to all. Authors can read a full description of the journal’s approach to open access publication online at,
- Although Value in Health is a traditional subscription-based journal, authors can choose to pay to have their articles published with open access (immediately and permanently free for everyone to read and download).
- The current fees for open-access publishing are accessible on the publisher’s website at www.elsevier.com/journals/value-in-health/1098-3015/open-access-options,
However, because Value in Health is a Society journal, all the published content automatically becomes open archive (freely accessible to all) 1 year after publication. Therefore, authors needing their articles to be open access to meet the requirements of various research competitions and awards may not need to pay for open access publication in Value in Health, depending on the precise requirements of their research funders.
In addition, the editors-in-chief nominate selected articles throughout the year that they believe are likely to have a high impact and therefore merit immediate “free” access on the publisher’s website at for a specified period of time (ie, 30 days). Access is restricted for the remainder of the 12-month period, after which point the article becomes open archive and freely accessible to all 1 year after publication.
Conflict of Interest and Copyright Assignment Forms All authors must disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work. As part of the online submission process, all authors are required to complete and submit the,
Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding. See also, Each author is also required to describe his/her involvement in the work and assign copyright of their papers.
Completion of the journal’s is a condition of publication and papers will not be passed to the publisher for production unless the Editorial Office has completed forms on file for each author. The journal’s authorship and copyright assignment form can be found online,
- A copy of this completed and signed form is acceptable; upload completed forms to the journal’s online submission system or email to,
- If excerpts from other copyrighted works are included, the author(s) must obtain written permission from the copyright owners and credit the source(s) in the article.
Elsevier has preprinted forms for use by authors in these cases; please consult,
- Retained Author Rights
- As an author you (or your employer or institution) retain certain rights; for details refer to,
- Funding Body Agreements and Policies
Elsevier has established agreements and developed policies to allow authors whose articles appear in journals published by Elsevier to comply with potential manuscript archiving requirements as specified as conditions of their grant awards. To learn more about existing agreements and policies please visit,
REFERENCES 1. Husereau D, Drummond M, Augustovski F, et al. Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) Explanation and Elaboration: A report of the ISPOR CHEERS II Good Practices Task Force. Value Health,2022;25(1):10-31.2. Eddy DM, Hollingworth W, Caro JJ, et al. Model Transparency and Validation: A Report of the ISPOR-SMDM Modeling Good Research Practices Task Force-7.
Value Health,2012;15(6):843-850.3. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ,2021;273(71).,4. Schulz KF, Altman DG, Moher D, for the CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials.
BMJ,2010;340:c332.5. Flanagin A, Frey T, Christiansen SL, et al. Updated Guidance on the Reporting of Race and Ethnicity in Medical and Science Journals. JAMA,2021;326(7):621-627.6. Chalmers I. The Cochrane Collaboration: Preparing, Maintaining, and Disseminating Systematic Reviews of the Effects of Health Care.
Ann NY Acad Sci,1993;703:156-165.7. AMA Manual of Style Committe. AMA Manual of Style: A Guide for Authors and Editors,10th ed. New York, NY: Oxford University Press; 2007.8. International Committee of Medical Journal Editors. Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals,
Updated December 2018. Accessed January 14, 2022.9. Committee on Publication Ethics. Accessed January 14, 2022.10. COPE Council. Ethical Guidelines for Peer Reviewers, www.publicationethics.org. Version 2. Published September 2017. Accessed January 14, 2022.11. International Committee of Medical Journal Editors.
Defining the Role of Authors and Contributors, Accessed January 14, 2022. : Guide for Authors