Cases in High Value Care

Curriculum for Teaching High Value Care in OB/GYN

Developed by: Dr. Lauren D. Demosthenes, Greenville Health System and Jennifer M. Keller, MD MPH, The George Washington University 

CREOGPhysicians have a responsibility to our patients and society to “do no harm” which includes providing cost-conscious medical care.  Recognizing overuse of medical care is difficult for physicians in the moment of providing clinical care and even more difficult to teach our trainees.
Practicing obstetrician/gynecologists have an important leadership role to play in practicing value-based care.  Integrating education in residency training about healthcare value will prepare residents to make high value, cost-conscious decisions in their practices and within the health systems in which they work.  
The CREOG Education Committee has developed several resources for Program Directors to help teach high value care in Obstetrics and Gynecology.

The curriculum consists of:

1Introductory Power Point

2. Cases in High Value Care:

3. Ways to use the Cases in your Residency Program 

  • On the fly while teaching around a clinical case
  • Have your residents design value improvement projects using the COST framework
  • Have your residents create a Value Based Care Case
  • Give the residents a High Value Care scenario (without the cost information) and ask them to identify the costs using the data available to them (websites, hospital/practice billing departments, etc)

4. Additional Resources 

5. Interested in writing a Case in High Value Care? 

  1. The goal of this series of clinical vignettes is to provide residency program directors with a way to teach resident physicians the cost of medical care using common clinical scenarios.  Upon submission, all cases are reviewed and may be edited for clarity, accuracy, and agreement with ACOG documents.   Once a case it accepted, it will be available on the CREOG website for 5 years, when it will be reviewed again to determine if the medical information and costs in the case are still appropriate.
  2. Instructions for authors:

    Clinical Scenarios: Outline two clinical scenarios (max 250 words each) that highlight two different ways the same patient could be managed.  One scenario should model cost- conscious care and the other scenario should model an alternative, less cost conscious plan of care.

    Discussion Questions: Create at least 2 discussion questions designed to facilitate discussion around the different ways the cases are managed and where unnecessary spending occurred. 

    Costs: List the approximate costs or charges of the patient encounter in both scenarios. Information on costs may be obtained from your hospital billing department, or from and should be referenced appropriately.  Cost will be defined as the amount that is typically paid by an insurance company for the billed visit or procedure or what your hospital has determined to be the cost to provide the care.  Note that this is different from the charge associated with a visit or procedure, which is what the hospital or provider would bill.  If unable to obtain cost information, you may use charges which are also available from your hospital billing department.  Be sure to clarify this in your case.

    Teaching Moment: Summarize the places where a high value change can occur without compromising patient care or clinical outcomes. (Maximum 250 words).

    References: Provide at least 2 references that are less than 5 years old for each teaching point.

*If you are a resident or medical student, you must have a faculty mentor review your case prior to submission.

Submit a Case

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998