Implementing value-based care for outpatient conditions in an Asian public healthcare system: framework and case studies from Singapore General Hospital

Background: Escalating healthcare expenditure and population aging have intensified interest in value-based care (VBC), particularly within publicly funded health systems. To date, most value-based initiatives and published implementation experiences have focused on inpatient or procedural care. In contrast, outpatient and longitudinal conditions pose distinct challenges for outcome definition, data availability, and care coordination, and remain relatively under-documented, especially in Asian healthcare contexts. Innovation: This paper describes and operationalizes a locally developed implementation framework designed to support condition-based, value-driven outcomes monitoring for outpatient care. Context: The framework was developed and applied in a large tertiary public hospital in Singapore that has expanded its value-based initiatives beyond nationally mandated programmes. Approach: We outline a four-stage implementation framework comprising scoping, exploration and analysis, baseline assessment, and improvement planning. The application of this framework is illustrated through two outpatient case studies: radioiodine therapy for hyperthyroidism and chronic pain management. Key lessons: Across both case studies, the framework facilitated systematic outcome selection, structured engagement between clinicians and administrators, and identification of actionable opportunities for care improvement, despite data and measurement constraints inherent to outpatient settings. Implications: This community case study provides practical insights into operationalizing value-based care for outpatient and chronic disease pathways and offers transferable lessons for health systems seeking to extend value-based care beyond inpatient and procedural contexts.