Enablers and challenges in implementing value-based healthcare in Dubai - Framework analysis

Background Despite global investments in healthcare, access to and quality of care remain inadequate, particularly in the Middle East, where value-based healthcare (VBHC) is still an emerging concept. This study investigates the enablers and barriers to VBHC implementation in Dubai, a city with a rapidly evolving healthcare landscape. However, there is no formal policy framework supporting the emerging and strategic initiatives of the Dubai health sector to incentivise quality of care as a success factor in healthcare. Purpose The study seeks to pinpoint factors that impact the implementation of VBHC, address the challenges that hinder its full potential, and suggest a roadmap for shaping future policies. Methods A qualitative methodology utilised semi-structured interviews with 17 key stakeholders, including regulators, payers, providers, administrators and consultants in the healthcare sector in Dubai. These interviews took place between June 2024 and October 2024, and the collected data was analysed thematically using NVivo software with deductive and inductive coding to identify enabler and challenge themes. The connections between the two lists were mapped using a theory of change model to design the most possible action plan to obtain optimal short-term outcome and long-term impact of VBHC. The results are aligned to be validated against literature recommendations specially the Porter's VBHC implementation agenda. Results The results reveal that the six key enablers of VBHC in Dubai include strong stakeholder engagement and awareness, robust data and technology infrastructure, and a clear regulatory framework. Conversely, seven challenges, such as poor data quality, resistance to change, and cultural barriers, were identified as critical obstacles. The discussion of the data raised a model to facilitate VBHC implementation, which focuses on improving data accuracy, fostering collaboration among stakeholders, and ensuring that reimbursement models align with desired patient outcomes. Conclusions The study provides insights for policymakers, healthcare leaders and providers in Dubai. It also highlights the critical steps needed to transition towards a healthcare system that reimburses for quality, prioritises value over volume, enhances patient outcomes, and reduces healthcare costs. While many gaps still need to be filled, a proposed policy framework and theory of change were illustrated as pathways to further improvement.