Health Value Added (HVA): Linking strategy, performance, and measurement in healthcare organizations

Nurit L. Friedman, Ehud Kokia, Joshua Shemer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


This paper describes "Health Value Added" - an innovative model that links performance measurement to strategy in health maintenance organizations. The HVA model was developed by Maccabi Healthcare Services, Israel's second largest HMO, with the aim of focusing all its activities on providing high quality care within budgetary and regulatory constraints. HVA draws upon theory and practice from strategic management and performance measurement in order to assess an HMO's ability to improve the health of its members. The model consists of four interrelated levels - mission, goals, systems, and resources - and builds on the existence of advanced computerized information systems that make comprehensive measurements available to decision makers in real time. HVA enables management to evaluate overall organization performance as well as the performance of semi-autonomous units. In simple terms, the sophisticated use of performance measures can help healthcare organizations obtain more health for the same money.

Original languageEnglish
Pages (from-to)3-8
Number of pages6
JournalIsrael Medical Association Journal
Issue number1
StatePublished - 1 Jan 2003


  • Health Value Added (HVA)
  • Health maintenance organization
  • Healthcare management
  • Organizational performance
  • Quality of care
  • Strategy


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