Core Competency:
Effectiveness
V1C providers and purchasers can use this core competency to learn about the varying levels of evidence available for different solution stages, considerations for evaluating V1C delivery models, and success indicators encompassing clinical, economic, patient, and provider experiences.
Effectiveness measures an organization’s ability to deliver valuable benefits to key stakeholders, including clinical outcomes, economic returns, and patient and workforce experience beyond conventional care delivery models.
The breadth and depth of evidence available varies depending on the platform’s maturity and experience. The most promising earliest-stage V1C solutions will have clear logic supporting simulation models. In contrast, established providers representing the best-in-class solutions will have published data generated from robust, well-controlled clinical studies in representative populations and appropriately structured economic analyses.
Maturity: Nascent
V1C delivery models have the potential to produce clinical outcomes equivalent to or exceeding those available through conventional care. However, there is still wide variability in the amount and types of data and performance measures reported by V1C providers to substantiate claims and the evidence required by partners.
- There is evidence of clinical outcomes that collects data from the earliest stages to support ongoing evidence generation, measures outcomes relevant to the condition and meaningful to patients, and conducts studies with populations, comparison groups, and study methodologies representative of real-world practice. It stratifies outcomes by equity measures and reduces or eliminates study bias using scientific best practices.
- There is evidence of economic returns in which models work within potential buyers’ cost structures, and their financial outcomes meet or surpass existing standards in the broader market. These studies demonstrate ROI and provide robust evidence from claims analysis to produce health economic studies.
- Produces satisfactory patient experience as measured by standard industry metrics, including Net Promoter Score (NPS) or Star Ratings in the top 80 percentile.
- There is evidence of sustained patient engagement, including enrollment and active participation measures.
- Produces satisfactory provider experience by supporting clinical team workflows, optimizing collaboration, and providing training.
Stakeholder perspectives on effectiveness
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Patients value convenience, access, and customer service when choosing a V1C provider over traditional care. Aligning with individual preferences and abilities for when, how, and where to receive care is an essential differentiator for V1C.
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Providers prioritize clinical outcomes and place a high value on designing workflows and care models that capture real-time clinic data and streamline administrative processes to deliver a positive patient experience.
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Payors seek robust clinical and economic outcome data that provide crucial information for the return on investment (ROI), while employers are concerned with member engagement and care coordination to reduce benefit plan costs.
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Investors seek V1C solutions with the potential to deliver outcomes that significantly outperform incumbents in one or more key dimensions: clinical, economic, and user experience/access. While they expect less evidence from early-stage companies, they value solid logic and a pathway to generating data.
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