Appropriate & Value Based Care (AVBC)

Appropriate and Value-Based Care (AVBC) is how SingHealth makes sure every patient gets the care that helps them most – supported by evidence, measured by outcome, and delivered with responsible use of healthcare resources

Part of a worldwide shift

Around the world, healthcare systems are shifting their focus from delivering more care to delivering better care.

Value-based healthcare traces back to work from Harvard's Michael Porter and Elizabeth Teisberg in 2006: stop competing on volume, start competing on the outcomes that matter to patients. This idea has built momentum through multiple countries, organisations and health systems worldwide.

In Singapore, the Ministry of Health launched the national Appropriate and Value-Based Care framework in 2025 to promote a value-conscious culture among policymakers, healthcare providers and practitioners care that is effective, evidence-based and centred on patients' needs. Another global initiative, Choosing Wisely, encourages conversations between healthcare professionals and patients about avoiding tests and treatments that may be unnecessary, or provide little benefit. Started in 2012 and is now active in over 30 countries.

At SingHealth, the Office of Value-Based Healthcare (OVBH) leads our AVBC efforts. We put these principles into practice by supporting evidence-informed care decisions, providing appropriate care and making the best use of healthcare resources to achieve better outcomes for our patients.

Why value? Why now?

Demand for healthcare is growing faster than the resources available to meet it. AVBC is based on a simple idea: good care is not just about providing more care, but the right care. By focusing on treatments and interventions that are proven to benefit patients, we can improve outcomes while using healthcare resources wisely.

In healthcare, “value” means achieving the health outcomes that matter most to patients, while making the best use of resources. Improving outcomes, using resources more effectively, or both, increase value.

When we raise the numerator (better outcomes), the co-benefits of healthcare sustainability, capacity and cost follow.

Our vision: transforming healthcare through value creation

What this looks like in practice (2025)

How we get there — three pillars, one goal

Appropriateness of Care — We make sure patients receive the care they need, when they need it. This means avoiding tests, treatments or procedures that are unlikely to help, while ensuring that beneficial care is not missed. Two key programmes support this work:

• Choosing Wisely — Encourages patients and healthcare professionals to discuss which tests, treatments and procedures are truly needed, helping to avoid care that offers little or no benefit.
• Patient-Reported Outcome Measures (PROMs) — Ask patients directly about their health, daily activities and quality of life. Their responses help healthcare teams understand whether treatment is making a meaningful difference and support better care decisions.

Value-Driven Care (VDC) — We use information about patients’ health outcomes and care experiences to understand how well care is working for specific conditions. By comparing results across healthcare teams and institutions, we can learn what works best, identify areas for improvement and deliver better care for patients.

Value-Based Contracting — We choose medicines, medical devices and healthcare supplies based on evidence of how well they improve patients’ health and whether they offer good value over the full course of care—not simply on their upfront price. This helps ensure that patients receive effective, cost-conscious care without having to worry about whether resources are being used wisely.

What makes the pillars possible

• Robust data and insights — Timely, reliable data helps us understand what is working, identify opportunities for improvement and support better decision-making.
• Implementation science — We use proven methods to implement improvements effectively and sustain them over time.
• Governance and accountability – Clear oversight and regular reporting help us track progress, measure impact and ensure our efforts remain focused.

Putting it together – VDC + Choosing Wisely + PROMs/PREMs

Each concept is not distinct; they interact and build on one another:

Each programme focuses on a different aspect of improving care and value, but all are measured using the same outcomes and cost indicators so that results can be compared fairly across the healthcare cluster.

By bringing together improvements from VDC, Choosing Wisely and PROMs, the overall Clinical Quality Index (CQI) provides a more holistic picture of value and quality of care delivered to patients.