{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"EP505: The Death of the \u201cWhat Is Value\u201d Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD","description":"Stacey Richter interviews neurosurgeon Dr. Ahilan Sivaganesan (Dr. Siva) about replacing vague healthcare \u201cvalue\u201d claims with quantified outcomes and unit-level costs, introducing his Operative Value Index (OVI). They discuss how hospitals often lack true internal episode costs and how common quality metrics miss patient-reported outcomes and appropriateness across the full care journey.  Using time-driven activity-based costing (TDABC) and condition- or procedure-specific patient-reported outcomes, OVI creates a common mathematical language to compare surgeons, practices, or health systems, risk-adjust for confounders, and support steering\/tiering and direct contracting for self-funded employers.   Siva describes transparency via bubble charts that spur clinician behavior change without new incentives and argues this infrastructure is essential as bundled payments and risk-based arrangements expand, framing a \u201cYahoo vs Google\u201d shift from fee-for-service volume to measurable value.  === LINKS === \ud83d\udd17  Show Notes with all mentioned links:   https:\/\/cc-lnk.com\/EP505 \u2709\ufe0f  Enjoy this podcast? Subscribe to the free weekly newsletter: https:\/\/relentlesshealthvalue.com\/join-the-relentless-tribe \ud83e\uded9  Support the podcast with a small donation to the Tip Jar: https:\/\/relentlesshealthvalue.com\/join-the-relentless-tribe \ud83c\udfa4  Listen on Apple Podcasts  https:\/\/podcasts.apple.com\/us\/podcast\/feed\/id892082003?ls= \ud83c\udfa4  Listen on Spotify  https:\/\/open.spotify.com\/show\/6UjgzI7bScDrWvZEk2f46b \ud83d\udcfa  Subscribe to our YouTube channel   https:\/\/www.youtube.com\/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === \u272d LinkedIn   https:\/\/www.linkedin.com\/company\/relentless-health-value\/ \u272d Threads  https:\/\/www.threads.net\/@relentlesshealthvalue\/ \u272d Bluesky   https:\/\/bsky.app\/profile\/relentleshealth.bsky.social \u272d X   https:\/\/twitter.com\/relentleshealth\/ 00:00 Introduction to this episode. 00:38 The goal of this episode. 01:28 What the Operative Value Index (OVI) is. 02:04 A quick episode overview. 04:23 EP434 with Benjamin Schwartz, MD, MBA. 04:44 How this episode came about. 09:24 How Dr. Siva got involved in the research around outcomes and costs. 11:51 How the value equation doesn\u2019t add up to true quality. 14:12 What measuring quality across the entire care journey means. 15:00 EP326 with Rishi Wadhera, MD, MPP. 15:08 EP295 with Rebecca Etz, PhD. 16:07 Why appropriateness is the foundation of quality. 19:08 Why practicing clinicians need to be thinking about the true costs of delivering care. 21:20 Time-driven activity-based costing (TDABC). 23:44 The two things that must be known for value-based care to succeed. 24:06 Article by Dana Prommel Strauss. 27:09 A quick summary of the conversation thus far. 30:42 The power of transparency in Dr. Siva\u2019s bubble plots. 32:39 EP449 with Marty Makary, MD, MPH. 34:05 Why these bubble plots work not just at the procedural level but at the diagnosis level, too. 36:13 EP503 with Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky. 36:21 EP501 with Ivana Krajcinovic, PhD. 36:30 EP398 with Jacob Asher, MD. 37:28 The \u201cbig blue ocean\u201d opportunity for forward-looking providers. 38:52 Substack post by John Lee, MD. 40:37 The incredible opportunity for entities and groups that can help provide the infrastructure needed for this value index. 41:42 Essay written by Dr. Siva. 43:19 Last thoughts by Dr. Siva on TDABC and competition on value.  ","author_name":"Relentless Health Value","author_url":"https:\/\/relentlesshealthvalue.com","html":"