Abstract
Physicians are estimated to be responsible for more than 50% of national healthcare costs and hold the greatest potential to improve value by orchestrating quality-driven programs to reduce unnecessary practices and variability. A physician's ability to practice cost-conscious care has been linked to their training, underscoring the importance of integrating cost-conscious practice into training.PURPOSEPhysicians are estimated to be responsible for more than 50% of national healthcare costs and hold the greatest potential to improve value by orchestrating quality-driven programs to reduce unnecessary practices and variability. A physician's ability to practice cost-conscious care has been linked to their training, underscoring the importance of integrating cost-conscious practice into training.The High Value Practice Academic Alliance was formed to help advance the value-improvement work of individual institutions through a national organization. We developed a curriculum and mentorship model for trainees throughout the country titled the Future Leaders Program (FLP). Upon entry to FLP, GME physicians completed a baseline self-assessment of their knowledge about costs, payment, and value in healthcare. Over 1 year, these physicians participated in structured educational activities related to high-value care (HVC), received mentorship focused on leading a value-based quality improvement (QI) project, and then completed a second self-assessment upon completion of the program.METHODSThe High Value Practice Academic Alliance was formed to help advance the value-improvement work of individual institutions through a national organization. We developed a curriculum and mentorship model for trainees throughout the country titled the Future Leaders Program (FLP). Upon entry to FLP, GME physicians completed a baseline self-assessment of their knowledge about costs, payment, and value in healthcare. Over 1 year, these physicians participated in structured educational activities related to high-value care (HVC), received mentorship focused on leading a value-based quality improvement (QI) project, and then completed a second self-assessment upon completion of the program.Over four academic years (AY17-18 through AY20-21), we had 161 respondents. Most participants report some prior education in healthcare value; however, many had never participated in a QI project. Participants showed variability in their knowledge. After completion of the program, paired sample t-tests demonstrated significant differences in the subscale scores for value knowledge (M = - 0.63, SD = 0.93), attitudes (M = - 0.46, SD = 0.45), and skills (M = - 0.40, SD = 0.71) indicating that participating in a value-focused QI project improved value knowledge, t(160) = - 9.66, p < .001; attitudes towards high-value care teaching, t(160) = - 12.48, p < .001; and high-value care practice frequency, t(160) = - 6.93, p < .001.RESULTSOver four academic years (AY17-18 through AY20-21), we had 161 respondents. Most participants report some prior education in healthcare value; however, many had never participated in a QI project. Participants showed variability in their knowledge. After completion of the program, paired sample t-tests demonstrated significant differences in the subscale scores for value knowledge (M = - 0.63, SD = 0.93), attitudes (M = - 0.46, SD = 0.45), and skills (M = - 0.40, SD = 0.71) indicating that participating in a value-focused QI project improved value knowledge, t(160) = - 9.66, p < .001; attitudes towards high-value care teaching, t(160) = - 12.48, p < .001; and high-value care practice frequency, t(160) = - 6.93, p < .001.Skills and knowledge are significantly improved after completion of our program, demonstrating that a free, web-based curriculum and tiered mentoring program can be effective in teaching HVC skills and preparing physicians to lead this work.CONCLUSIONSSkills and knowledge are significantly improved after completion of our program, demonstrating that a free, web-based curriculum and tiered mentoring program can be effective in teaching HVC skills and preparing physicians to lead this work.