Key Differences Within the Patient-Perspective Value Framework

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Our experts discuss the key differences making the the Patient-Perspective Value Framework 1.0 (PPVF) unique compared to value frameworks currently in the market.
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“All of that said, we are really thinking long term about how might one use this as a tool for shared-decision making and how can we help to drive forward more robust decision aids that patients can use in collaboration with their clinicians.” Josh Seidman, Avalere


Josh Seidman , Managing Director, Center for Healthcare Transformation

Josh Seidman advises clients on health delivery and payment innovation with a focus on using information technology to guide value-based care models.

This interview was originally published as a podcast. The audio is no longer available, but you can read the transcript below. For updates on our newly released content, visit our Insight Subscription page.


Alex: Hi, I’m Alex Goolsby, Vice President at Avalere Health. I’m here with Josh Seidman who leads our Center for Payment and Delivery Innovation. Today we’re going to talk a little about the Patient-Perspective Value Framework.

Alex: Josh, one of the things that I think people are interested in understanding is where did the Patient-Perspective Value Framework come from, why is it important, and most importantly what makes it different from other value frameworks on the market?

Josh: Yeah, this is something that we came to about 2 years ago when there was this proliferation of value frameworks in the marketplace. So organizations like ICER, ASCO, NCCN. They were coming out with these value frameworks and we absolutely believe it’s really important that we generate a deep conversation about value as we move toward a value-based payment environment.

That said, it’s also equally important that that value equation incorporates the perspective of patients in it. And there were some concerns from other organizations namely FasterCures, a non-profit center of the Milken Institute, that came to us with some questions about what do these frameworks look like when examined through the lens of the patient. That led us down this road and ultimately it created a whole initiative which has a group of many stakeholders from throughout the healthcare industry involved. We have a steering committee of 2 dozen organizations, patient advocacy groups, payers, life sciences companies, researchers, and government agencies that have been engaged as well. Through that process we have come up with this framework to really get in-depth as to how do patient preferences affect how one thinks about value and then looking at the various domains of value through that lens. So things like patient-centered outcomes, the patient and family costs rather than just looking at system-wide costs and other domains as well.

Alex: You know I know you engaged patient groups and the voice of the patient in developing the Patient-Perspective Value Framework in Phase 1 of the work. There was a very interesting anecdote that came out of those discussions and I was hoping you could share that?

Josh: Sure, you know when we tested out this framework with real patients and caregivers we did some focus groups and one of them was with cancer patients in Philadelphia. And one of the things as we got in-depth on this, we had a pretty large list of criteria and measures. We were concerned that this list of criteria and measures might be overwhelming to cancer patients. And so we presented it to them. They actually told us to some degree the opposite. They said, “you know what this is a long list but guess what I’ve had to deal with all these things when I have gone for my treatment. These were all cancer patients that had been diagnosed at least a year ago.” They said, “you know I’ve had to deal with these things but I didn’t know it when I started my treatment.” If I had had a checklist like this at the beginning of my treatment or along the journey of my treatment it would made things a lot easier for me because I would have known what questions to ask my doctor and what issues to discuss with my family.

Alex: That’s powerful! So the steering committee just kicked off Phase 2 of the Patient-Perspective Value Framework and one of the goals in Phase 2 is to get the tool into the hands of patients and providers. What do you see as being some of the core activities for Phase 2 of the PPVF as it relates to the steering committees activities?

Josh: Yeah, we’re going to be working on the specific applications or use cases of the PPVF. So one of them is thinking about how it might be used to enhance other frameworks. We continue to engage in constructive dialogue with those other framework developers to see how some of these issues like patient-centered outcomes can better support those frameworks and how they can be measured under their approaches.

We also are working with CMS on how this might fit into future measurement, their quality improvement activities, and how they’re evolving their new alternative payment models to what extent can shared-decision making and the better use of clinical decision support be integrated into those models.

And then we certainly are figuring out how to develop a scoring methodology that can be used in the application of this framework to very specific condition use cases. All of that said, we also are really thinking long term about how might one use this as a tool for shared-decision making and how can we help to drive forward more robust decision aids that patients can use in collaboration with their clinicians.

Alex: Great, thanks Josh for your time. We look forward to hearing about all of the success of the Patient-Perspective Value Framework Phase 2 and we look forward to catching up with you in another podcast.

Josh: Sounds great.

To learn more about updates to the PPVF, read our press release.

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