To define the concept of value-based care in allergy, and to review challenges and opportunities in value-based healthcare delivery for allergists and immunologists.
Articles describing practice variation, healthcare financing and reimbursement, shared decision making, cost-effective healthcare delivery, patientreported outcome measures, social determinants of health, and screening.
A narrative review detailing concepts and approaches to improve value-based healthcare in the context of the Quadruple Aim to address the patient and physician experience, cost, and population health.
Efforts to improve cost-effective care can be informed by understanding unwarranted geographic practice variation and benchmarking best practice. While evidence suggests that shared decision making and addressing social determinants of health have critical roles in high-quality care, some practices such as routine laboratory screening for urticaria, premedication to prevent recurrent low or iso-osmolar contrast reactions, extended observation of resolved anaphylaxis, food allergy screening, and penicillin allergy overdiagnosis have high costs in relation to overall societal benefit. Food allergy prevention, newborn screening for SCID, and penicillin delabeling are examples of population-based opportunities in which allergists and immunologists can assist in creating heath care value. Although efforts to incentivize value-based care have emerged in recent years, the degree to which process measures improve patientimportant outcomes remains uncertain. Clinician wellness must be made a priority for continued effective practice.
As healthcare systems continue to evolve, allergists and immunologists will play a key role in optimizing value by translating emerging evidence into practice and communicating novel approaches to prevent and treat allergic diseases.

Copyright © 2020. Published by Elsevier Inc.