Learning Objectives: At the end of this activity, you will be able to:

• Explain at least two motivations for health systems to move to a value-based care model.
• Discuss the role of front-line providers and employers in identifying waste in a health care system.

Description: Neel Shah, MD, MPP, an obstetrician/gynecologist at Beth Israel Deaconess Medical Center, has been passionate about reducing costs and waste in the health care system since he started practicing. Why has the time come for value-based care? And what’s one easy way to identify waste in a system?

Discussion Questions:

1. What role do patients play in determining cost and quality in health care? What role do policy makers and payers play? 
2. In comparing a health care system to a cost center, Neel says, “The way to protect our margins is to figure out where the waste is — and get rid of it.” How might you identify waste where you work? 
3. Think of a time you were the “lowest on the totem pole” in a professional setting. What waste or inefficiencies did you identify? Did you fix it? Why or why not?