Gomes, João MarquesSobottka, Louisa2025-07-312025-07-312025-01-092025-01-29http://hdl.handle.net/10362/185799This thesis explores the sustainable implementation of Value-Based Health Care (VBHC) by developing a self-guiding, adaptive framework tailored to global healthcare contexts. Existing linear approaches have resulted in fragmented adoption due to systemic barriers and lack of sustainable integration. The proposed 'hammer-throw model' addresses these challenges with a flexible, evolving strategy that emphasizes iterative processes, including contracting, financial incentives, communication and cultural change. Based on a literature review and 12 high-level expert interviews, this model offers hospitals as well as health care organisations a roadmap for transitioning from volume-based to value-based care, with a focus on sustainability and patient-centred outcomes.engValue based health careImplementationChange managementPatient centered caremaster thesis203959620