At a time when healthcare costs have become a sustainability concern globally, value-based care has emerged as a path to address future healthcare challenges while maintaining a focus on improving patient outcomes. In the UAE, the Dubai Health Authority’s (DHA) Dubai Health Insurance Corporation (DHIC) announced last year the launch of a first-of-its-kind value-based healthcare model for the Emirate, jumpstarting a new era in healthcare services.
The new initiative, known as EJADAH, is an innovative approach aimed at not only enhancing the quality of healthcare but also prioritising preventive care.
“EJADAH will work towards ensuring that Dubai’s healthcare sector becomes more sustainable and patient-centric going forward, with incentivising improvements in value – rather than volume – through alternative payment models,” according to DHIC consultant, Dr. Mohamed Farghaly, Family Medicine Consultant, Diabetologist and Professor of Medicine at Dubai Medical Collage.
Value-based care seeks to improve patient outcomes and elevate the patient experience while managing the efficiency of care and reducing unneeded costs within the healthcare system. It represents a system where providers are rewarded based on positive patient outcomes, quality, and efficiency. By pinpointing areas where quality improvements can be made, healthcare systems then can focus their resources more effectively on care paths that benefit their patients most.
Adoption of the Current Procedural Terminology (CPT) code set for use in the healthcare system in Dubai enables greater transparency to identify overlooked opportunities, such as preventive care or underutilised healthcare practices. The CPT code set is a medical terminology maintained by the American Medical Association (AMA) and forms the backbone of healthcare data interoperability in the UAE today. CPT codes support new and novel care delivery models by accurately describing the services and treatments patients receive and classifying healthcare data to reduce administrative burden and improve patient and public health outcomes. Furthermore, data classified by the CPT code set enables stakeholders, who manage limited resources, to benchmark quality measurements for patient cohorts and share care service and resources more equitably.
Use of the standardised CPT code set aligns with the mission of healthcare systems to enhance the quality of patient care while optimising cost-efficiency. Here are some examples of how CPT content contributes to these alternative payment models:
- Link cost and quality measures: CPT codes allow for standardised reporting of healthcare services, so that care can be accurately documented. Healthcare systems and providers can evaluate the cost-effectiveness of their discrete services. Additionally, the standardisation allows for the tracking and comparing of quality measures, so that patient care can be aligned with best practices and benchmarks, thus enhancing the quality of care delivered.
- Digitally enabled care and emerging technologies: With the advent of telemedicine, wearable devices, and health monitoring apps, CPT content accurately represents the services provided in a digital care setting. This not only allows for the efficient delivery of care but also enables new avenues for preventive healthcare. For example, remote monitoring and telehealth visits can help patients manage chronic conditions and receive timely interventions, reducing the overall cost of care while improving patient outcomes.
- Coordination of patient care: With CPT codes providing a standardised language, healthcare professionals can seamlessly communicate and coordinate patient care across different modalities, providers and specialties, helping them provide patients holistic and well-coordinated care. In a value-based model, this collaborative approach that CPT content facilitates can lead to better patient outcomes and reduce duplicative services and unnecessary costs.
CPT content continues to empower healthcare systems to accurately describe medical procedures and services, elevate quality, improve productivity, manage costs, and thus expand patient access. The DHA's commitment to launching EJADAH represents a positive step for new value-based models “that will no doubt also pave the way and inspire other territories in the region to consider similar approaches,” according to Dr. Farghaly.
As healthcare delivery transforms in the GCC region, pioneering developments serve as an inspiration for a healthier future. Value-based care with the CPT code set at its foundation holds promise as an effective healthcare delivery system that remains patient-centric and contributes to sustainable healthcare services across the region and beyond.
About the Current Procedural Terminology (CPT) code set
The Current Procedural Terminology (CPT) code set curated by American Medical Association (AMA) is a comprehensive, standardised language that seeks to empower physicians and health systems to improve quality, increase access, and lower costs. Frequently updated and trusted for more than 50 years, the CPT code set enables innovative clinical practices and technologies that support the modern delivery of care.
Chris Jagmin, M.D. is the Chairperson, CPT Editorial Panel
