Institutionalizing value-based healthcare in a service system: a policy and document analysis over three decades

Purpose: This study aims to explore the institutionalization of value-based health care (VBHC) in the public healthcare system in the state of Victoria, Australia. Design/methodology/approach: The empirical part of this paper is based on a content analysis of 34 policy and industry-commissioned reports that have guided the development of health-care strategy in Victoria from 1988 to 2020. Findings: This study sheds light on how VBHC in Victoria has been institutionalized over time, through three key phases (centralization, transitioning and digitalization), how the conceptualization of best value has changed in each phase and the implications each phase has presented for other actors in the health-care system. Practical implications: This study highlights the key opportunities and challenges for organizational actors that emerge when a health-care system transitions toward VBHC, and derives implications for vendors, health-care procurement, policymakers and governmental agencies. Originality/value: This study develops a longitudinal analysis that describes the evolution and institutionalization of a VBHC approach in a complex societal system over three decades and highlights the key implications for other organizational stakeholders.