Challenges, experiences, and lessons learned in Argentina and the region in the quest to add value to healthcare, according to participants in a new Value-Based Healthcare Community Open House organized by IECS.
On the afternoon of Tuesday, September 2, approximately 4 attendees participated in the XNUMXth Open Day of the Value-Based Healthcare Community, organized by the Institute for Clinical and Healthcare Effectiveness (IECS). This event was a collaborative and cross-disciplinary space where relevant stakeholders from Argentina and the region shared challenges and experiences in the effort to sustainably improve patient outcomes.
“Unless we integrate all the actors involved—funders, technology producers, providers, and patients or users—the system cannot change. We need these discussions to transform the current reality toward a value-based system, because we urgently need to change patient outcomes and experience and make it viable in terms of economic sustainability,” said the Dr. Ezequiel García Elorrio, a specialist in internal medicine, a doctor of medicine, with a master's degree in epidemiology and business administration, and director of the Department of Quality, Patient Safety and Clinical Management at IECS.
The afternoon meeting was opened by Mr. Gabriel Oriolo, head of the Superintendency of Health Services (SSS) from January 2024 to June 2025, who considered that Argentina's health system, like those in the West, faces three problems: demographic changes ("a sharp drop in births and an increase in life expectancy"), a shortage of medical professionals, and rising drug costs.
The next speaker, Dr. Waldo Ortega Flores, family physician and head of the Value-Based Healthcare Unit at Clínica Alemana in Santiago, Chile, emphasized that practicing good medicine is “doing what needs to be done, to the right person, at the right time, and with the right resources.” Dr. Ortega posited that “there is no value-based healthcare without people-based care, without efficiency, and without continuous improvement.”
Dr. Carlos Kerguelén, a surgeon with a master's degree in health management policy and planning and deputy director of Clinical Performance Metrics at the Santa Fe de Bogotá Foundation in Colombia, stated that there are a number of more or less established structural elements to a Value-Based Healthcare agenda that pose the challenge of how to put them into practice in specific settings. "You can't just stick to the nice rhetoric of working on value; you have to get down to the nitty-gritty to develop it," emphasized Dr. Kerguelén.
“We learn more from failure than from success”
What are some key factors for implementing Value-Based Healthcare? Why are value-based systems essential today?
In the first of three panels, four stakeholders from different industries shared their perspectives. Giselle Tutor Oportus, Director of Market Access, Innovation, and Public Affairs at Medtronic Latin America South, emphasized the need to reconnect with the purpose of all those working in the healthcare sector: saving lives and delivering better services. Working on value "has to do with the context that is pressing us and forcing us to rethink the model, but it is also a reminder to each of us why each of us works in this sector and not another," she stated.
Dr. Carolina López Canelo, Country Lead for Sanofi Argentina, stated that the pharmaceutical industry is aware that treatment innovation "will make sense as long as it can be accessible to all those who need it."
For his part, Dr. Leonardo Garfi, deputy medical director and head of Strategic Planning at the Italian Hospital of Buenos Aires, stated that healthcare systems around the world are facing a “powerful crisis” on multiple levels, but the first of these is not a crisis of costs or budgets, but rather a crisis of value: “We are seeking to align a number of different visions to try to save a system that, ultimately, must also save us, since we are ultimately going to be patients,” he stated.
Dr. Gabriel Novick, corporate medical director of Swiss Medical Group, former Undersecretary of Health for the City of Buenos Aires, and visiting professor at several foreign universities, drew attention to the fact that the healthcare industry's waste level reaches 30%, almost double that of the fruit industry and fifteen times higher than that of the automotive industry. "Value-based medicine adds more value for the money invested in healthcare. It's not an option; it's a necessity to continue having access to the innovation that the healthcare industry provides," he emphasized.
“A leap of faith”
In another panel, four speakers shared experiences and lessons learned from implementing Value-Based Healthcare initiatives.
Dr. Santiago Catalán Pallet, deputy chief of Rheumatology at Austral University Hospital and director of the Comprehensive Outpatient Management project at the same institution, reflected that working in Value-Based Healthcare is not about achieving a short-term result, but rather "taking a leap of faith together with others who are taking that leap with you." He then shared the challenges and progress made in the implementation strategy of an integrated practice unit for treating outpatients with type 2 diabetes. This unit is comprised of three key players in the health system: the institution, the health plan, and the industry (in this case, the Roche laboratory), to define a standardized "patient pathway" and minimize waste in the process. He anticipated the first results will be available next month.
La Dr. Karin Kopitowski, a family doctor and director of the Research Department at the University Institute of the Italian Hospital in Buenos Aires, noted that for many years she has wondered why it's so difficult to stop doing what shouldn't be done. "20-30% of what we do in healthcare is of low value. And the biggest problem with low-value practices is that they have the potential to cause harm. And that's why the cultural change we need to make is that more isn't always better, and that if it's not necessary, it can cause harm," she emphasized.
Accountant Gabriel Mulero, general manager of Los Pinos, an organization with over 100 years of experience in Argentina providing care for older adults and comprehensive rehabilitation for adults with functional limitations, discussed a series of transformations in recent years to reinvigorate the management of a tertiary center where the client makes all the decisions. "The perceived value goes beyond medicine; it involves the treatment, how they treat you or how the food is served. And we have to give value to the family group as well," he emphasized.
Dr. Federico Levy, a nephrologist with a master's degree in interventional and diagnostic nephrology and a member of the Medtronic LATAM medical sciences team, presented data on the evolution of the company's value proposition in Argentina and the region, consisting of an outcome protection program for high-cost devices for common cardiovascular conditions. To date, more than 100 such programs have been implemented in six countries. "It's a mechanism by which we share the risk and can reimburse or compensate the payer when things don't go as expected, not due to device failure, but due to the progression of the disease itself," he said.
The panel was closed by Dr. Matías Mirofsky, deputy head of the Internal Medicine Service at the “Dr. Leónidas Lucero” Municipal Acute Care Hospital in Bahía Blanca, who presented on the development and initial results of a home hospitalization project at his institution. The initiative took shape in late 2022 and sought to optimize the capacity to respond to the demands of the majority of the population. The results of the first two years have been very satisfactory: with more than 550 home hospitalizations, the readmission rate was 17%, the patient and family acceptance rate was over 95%, and the cost per bed was lower than that of conventional hospitalization. Some lessons learned? “Crisis situations also open up opportunities; the public subsystem can also implement value strategies; resistance to change among professionals can be modified; and in the cost-benefit equation, everyone benefits,” he stated.
The day concluded with a panel on Digital Health with a Value Purpose featuring Dr. Alfonso Fernández Pazos, a physician specializing in internal medicine and holding a Master's in Business Administration (MBA), who describes himself as "passionate about digital transformation in the healthcare sector" and is the medical director of Innovamed, a company that offers digital solutions for physicians, pharmacies, healthcare institutions, and patients; Dr. Federico Pedernera, a physician specializing in medical informatics, MBA, former Undersecretary of Epidemiological Surveillance, Health Information, and Statistics at the Ministry of Health, and current CEO of Innovamed; and Mr. Pablo Kruls, MBA, co-founder and commercial director of Motivia, a platform that improves treatment adherence for chronic and rare diseases; and Dr. Gustavo Daquarti, cardiologist and data scientist, co-founder and AI leader of ÜMA Salud AI, an artificial intelligence-powered platform that seeks to provide agile, secure, and high-quality access to healthcare services by combining technology and telemedicine. “Technological solutions can bring real value to the healthcare system,” they agreed.