Accounting for value-based management of healthcare services: challenging neoliberal government from within?

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Abstract

This paper examines the political rationality and governing technology underpinning value-based management (VBM) in the Danish healthcare system. VBM is a neoliberal mode of governing healthcare via competitive pay-for-performance schemes. At the same time, it has somewhat paradoxically cleared a space for criticising such neoliberal schemes. VBM implies an insatiable demand for knowledge that seeks to map the health outcomes and costs of treatment; a demand challenging the neoliberal governmentality that informs it.

Management scholars have inspired a new series of reforms that, under the heading of ‘value-based management’, seeks to link hospital funding to accounts of actual treatment outcomes and costs. Based on the Danish experience, this paper suggests that the shift from a pay-for-performance system based on narrow conceptions of output, such as the number of patients treated, to one measuring actual health outcomes for patients is promising. However, the requirement for extensive knowledge linking health outcomes to full cycle treatments and their costs significantly challenges the adoption of a fair pay-for-performance system.
Original languageEnglish
JournalPublic Money and Management
Volume42
Issue number3
Pages (from-to)199-208
Number of pages10
ISSN0954-0962
DOIs
Publication statusPublished - 2022

Bibliographical note

Important note from the Publisher regarding the attached version of the article: “This is an Accepted Manuscript version of the following article, accepted for publication in Public Money & Management. Peter Triantafillou (2022) Accounting for value-based management of healthcare services: challenging neoliberal government from within?, Public Money & Management, 42:3, 199-208, DOI: 10.1080/09540962.2020.1748878. It is deposited under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.”

Keywords

  • Hospital management
  • Neoliberalism
  • pay-for-performance schemes
  • power
  • Value-based Management

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