A Paradigm Shift in Healthcare: An Open Door for Organizational Behavior Management
Value-based healthcare payment gives BCBAs a ready market for OBM to boost quality scores and cut costs.
01Research in Context
What this study did
Kelley and co-authors scanned the healthcare world. They saw hospitals switching from fee-for-service to value-based pay.
The team wrote a story-style review. They asked: can OBM tools help clinics hit new quality targets and keep the money coming?
What they found
The paper says yes. When payers reward better patient outcomes, leaders look for data-driven ways to improve care.
That search opens the door for BCBAs to sell performance-management packages—task analyses, pinpointing, feedback loops—to hospitals and medical practices.
How this fits with other research
Fujita (1985) warned that unless behavior analysts speak up, others will twist our message. Kelley et al. answer: healthcare reform gives us a built-in microphone—quality metrics we already know how to shape.
Horner et al. (2022) push for tighter single-case design. Kelley’s group agrees on rigor, but shifts the spotlight from lab studies to large-scale hospital systems where the dependent variable is patient safety, not just response rate.
Davison et al. (2005) claim science rewards flashy new results and buries replications. Kelley flips the contingency: value-based pay rewards steady, measurable improvement—exactly the kind of boring-but-reliable data OBM produces.
Why it matters
If you can write a task analysis for tooth-brushing, you can write one for hand-washing before surgery. Offer a pilot project on one nursing unit, track infection rates over the study period, and show the CFO the saved costs. One win turns into a hospital-wide contract.
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02At a glance
03Original abstract
The United States spends more money on healthcare each year than any other country in the world (OECD, 2015). Despite high costs, the quality of healthcare is below average, resulting in a society that is far from “getting what it pays for.” High costs and poor quality have resulted in a recent paradigm shift from traditional fee-for-service systems where hospitals and providers were paid by volume of patients to value-based care, to where they are now paid by quality of care (Andel, Davidow, Hollander, & Moreno, 2012). This shift has pressured organizations to improve quality of care at a rapid pace. This paper seeks to assess how Organizational Behavior Management has helped address the quality of healthcare thus far and discuss avenues for future research and practice.
Journal of Organizational Behavior Management, 2018 · doi:10.1080/01608061.2017.1325824