The Challenges Ahead: Concepts, Analytics, and Ethics of Value-Based Care in Applied Behavior Analysis
Cox, D. J. (2024). The Challenges Ahead: Concepts, Analytics, and Ethics of Value-Based Care in Applied Behavior Analysis. Behavior Analysis in Practice, 1–18. https://doi.org/10.1007/s40617-024-00937-x
Value-based care has incrementally increased its footprint across healthcare over the past 2 decades. Several organizations in ABA have begun experimenting with various components of value-based care specific to the delivery of ABA services, and this trend will likely continue.
For those new to value-based care, this article reviews the main conceptual components and common myths and misconceptions about value-based care. Though conceptually straightforward, practically pulling off value-based care in ABA will require significant advancements in data collection, analytics, sharing, and transparency that follow from broad field-wide collaboration.
Further, many ethical questions will likely arise as ABA providers begin thinking about and assessing their clinical and business operations through a value-based care lens. Though value-based care will likely roll out slowly and incrementally over many years, ABA providers interested in participating or leading these conversations will likely benefit from focusing collaborative efforts around normalizing data sharing and self-analysis, defining and developing quality and cost measures, identifying patient risk variables; addressing challenges at the intersection of public health ethics and clinical ethics; and addressing challenges at the intersection of AI ethics and clinical ethics. Most probably agree that optimizing patient outcomes is the goal of ABA services. However, doing it in an objective, measurable, and consistent manner that third parties can validate will require overcoming significant challenges.
