GET https://rct.dev.bbntimes.com/science/how-to-deliver-value-based-surgical-care

Response
200 OK
IP
18.191.62.45
Profiled on
Token
08db16

ArticleController :: show

Request

GET Parameters

None

POST Parameters

None

Uploaded Files

None

Request Attributes

Key Value
_controller 
"App\Controller\ArticleController::show"
_firewall_context 
"security.firewall.map.context.main"
_links 
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    3768 => Symfony\Component\WebLink\Link {#3768
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      -attributes: [
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    3767 => Symfony\Component\WebLink\Link {#3767
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      -attributes: [
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    3766 => Symfony\Component\WebLink\Link {#3766
      -href: "/build/app.js"
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      -attributes: [
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      -attributes: [
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    }
    3763 => Symfony\Component\WebLink\Link {#3763
      -href: "/build/contact.js"
      -rel: [
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      -attributes: [
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    }
    3762 => Symfony\Component\WebLink\Link {#3762
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      -rel: [
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      -attributes: [
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    }
    3761 => Symfony\Component\WebLink\Link {#3761
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      -rel: [
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      -attributes: [
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      ]
    }
    3760 => Symfony\Component\WebLink\Link {#3760
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      -attributes: [
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      ]
    }
    3759 => Symfony\Component\WebLink\Link {#3759
      -href: "/build/term-condition-css.css"
      -rel: [
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      -attributes: [
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    3758 => Symfony\Component\WebLink\Link {#3758
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      -rel: [
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      -attributes: [
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    3757 => Symfony\Component\WebLink\Link {#3757
      -href: "/build/comment-css.css"
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      -attributes: [
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_route 
"article_show"
_route_params 
[
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_security_firewall_run 
"_security_main"
_stopwatch_token 
"9ab627"
category 
"science"
slug 
"how-to-deliver-value-based-surgical-care"

Request Headers

Header Value
accept 
"*/*"
accept-encoding 
"gzip, br, zstd, deflate"
connection 
"close"
cookie 
"care_did=95905d16-c40d-4356-82de-7a4c61ebc0df; laikanxia_google_v=1; laikanxia_cookie_id=250222165546900; PHPSESSID=qgjpoenadlref36vhb40efhagp"
host 
"rct.dev.bbntimes.com"
user-agent 
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
x-php-ob-level 
"1"

Request Content

Request content not available (it was retrieved as a resource).

Response

Response Headers

Header Value
cache-control 
"no-cache, private"
content-type 
"text/html; charset=UTF-8"
date 
"Sat, 22 Feb 2025 08:56:04 GMT"
link 
"</build/runtime.js>; rel="preload"; as="script",</build/644.js>; rel="preload"; as="script",</build/502.js>; rel="preload"; as="script",</build/app.js>; rel="preload"; as="script",</build/view-more.js>; rel="preload"; as="script",</build/term-condition.js>; rel="preload"; as="script",</build/contact.js>; rel="preload"; as="script",</build/scroll-infinite-article.js>; rel="preload"; as="script",</build/app.css>; rel="preload"; as="style",</build/cookie-style.css>; rel="preload"; as="style",</build/term-condition-css.css>; rel="preload"; as="style",</build/contact-css.css>; rel="preload"; as="style",</build/comment-css.css>; rel="preload"; as="style""
x-debug-token 
"08db16"

Cookies

Request Cookies

Key Value
PHPSESSID 
"qgjpoenadlref36vhb40efhagp"
care_did 
"95905d16-c40d-4356-82de-7a4c61ebc0df"
laikanxia_cookie_id 
"250222165546900"
laikanxia_google_v 
"1"

Response Cookies

No response cookies

Session 6

Session Metadata

Key Value
Created 
"Sat, 22 Feb 25 08:55:55 +0000"
Last used 
"Sat, 22 Feb 25 08:56:02 +0000"
Lifetime 
0

Session Attributes

Attribute Value
_csrf/https-comment 
"qIXzDPxcr8lE4bKPtDwXIF4zPXC-ghhroJDtX1ucGOQ"
_csrf/https-cookie_accept 
"pPAsf3DdXHB7QnQl_DIoOnazJBrdiaZYKlAepE5PwwU"

Session Usage

6 Usages
Stateless check enabled
Usage
Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:76
Show trace 
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Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:79
Show trace 
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Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:52
Show trace 
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  [
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Symfony\Component\Security\Csrf\TokenStorage\SessionTokenStorage:56
Show trace 
[
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    "function" => "createView"
    "class" => "Symfony\Component\Form\Form"
    "type" => "->"
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  [
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    "line" => 181
    "function" => "show"
    "class" => "App\Controller\ArticleController"
    "type" => "->"
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    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/http-kernel/HttpKernel.php"
    "line" => 76
    "function" => "handleRaw"
    "class" => "Symfony\Component\HttpKernel\HttpKernel"
    "type" => "->"
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    "line" => 197
    "function" => "handle"
    "class" => "Symfony\Component\HttpKernel\HttpKernel"
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    "function" => "handle"
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    "type" => "->"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/autoload_runtime.php"
    "line" => 29
    "function" => "run"
    "class" => "Symfony\Component\Runtime\Runner\Symfony\HttpKernelRunner"
    "type" => "->"
  ]
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    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/public/index.php"
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    "args" => [
      "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/autoload_runtime.php"
    ]
    "function" => "require_once"
  ]
]
Symfony\Component\Security\Core\Authentication\Token\Storage\UsageTrackingTokenStorage:41
Show trace 
[
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/security-core/Authentication/Token/Storage/UsageTrackingTokenStorage.php"
    "line" => 41
    "function" => "getMetadataBag"
    "class" => "Symfony\Component\HttpFoundation\Session\Session"
    "type" => "->"
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    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/twig-bridge/AppVariable.php"
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    "function" => "getToken"
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    "function" => "twig_get_attribute"
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    "function" => "handle"
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    "function" => "handleRaw"
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    "type" => "->"
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    "function" => "handle"
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    "function" => "run"
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  [
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    "line" => 5
    "args" => [
      "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/autoload_runtime.php"
    ]
    "function" => "require_once"
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]
Symfony\Component\Security\Http\Firewall\ContextListener:171
Show trace 
[
  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/security-http/Firewall/ContextListener.php"
    "line" => 171
    "function" => "remove"
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  [
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    "function" => "onKernelResponse"
    "class" => "Symfony\Component\Security\Http\Firewall\ContextListener"
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    "function" => "__invoke"
    "class" => "Symfony\Component\EventDispatcher\Debug\WrappedListener"
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    "function" => "callListeners"
    "class" => "Symfony\Component\EventDispatcher\EventDispatcher"
    "type" => "->"
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    "class" => "Symfony\Component\EventDispatcher\EventDispatcher"
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  [
    "file" => "/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/vendor/symfony/http-kernel/HttpKernel.php"
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    "function" => "filterResponse"
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Flashes

Flashes

No flash messages were created.

Server Parameters

Server Parameters

Defined in .env

Key Value
APP_ENV 
"dev"
APP_SECRET 
"0a988e63f011514eaabfc650b599af4d"
CORS_ALLOW_ORIGIN 
"*"
DATABASE_URL 
"mysql://bbndb_rctuser:33F5W25z40or0f7@localhost:3306/rct_bbntimes"
GOOGLE_RECAPTCHA_SECRET_KEY 
"6LdV5fgpAAAAANxzTG8ZMfIjil1wu-1vrQvnUt-x"
GOOGLE_RECAPTCHA_SITE_KEY 
"6LdV5fgpAAAAAENKcn73MJAhQrbtQeqgyC4wDLMP"
MAILER_DSN 
"smtp://no-reply%40rct.dev.bbntimes.com:Bl6%26gLD48%26Of919@rct.dev.bbntimes.com:465"
MARIADB_PASSWORD 
"i!87pK&!85ezc8"

Defined as regular env variables

Key Value
APP_DEBUG 
"1"
BASE 
"/public"
CONTEXT_DOCUMENT_ROOT 
"/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com"
CONTEXT_PREFIX 
""
DOCUMENT_ROOT 
"/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com"
FCGI_ROLE 
"RESPONDER"
GATEWAY_INTERFACE 
"CGI/1.1"
HTTPS 
"on"
HTTP_ACCEPT 
"*/*"
HTTP_ACCEPT_ENCODING 
"gzip, br, zstd, deflate"
HTTP_CONNECTION 
"close"
HTTP_COOKIE 
"care_did=95905d16-c40d-4356-82de-7a4c61ebc0df; laikanxia_google_v=1; laikanxia_cookie_id=250222165546900; PHPSESSID=qgjpoenadlref36vhb40efhagp"
HTTP_HOST 
"rct.dev.bbntimes.com"
HTTP_USER_AGENT 
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
PASSENGER_COMPILE_NATIVE_SUPPORT_BINARY 
"0"
PASSENGER_DOWNLOAD_NATIVE_SUPPORT_BINARY 
"0"
PATH 
"/usr/local/sbin:/usr/local/bin:/usr/sbin:/usr/bin:/sbin:/bin:/snap/bin"
PHP_SELF 
"/public/index.php"
PP_CUSTOM_PHP_CGI_INDEX 
"plesk-php81-fastcgi"
PP_CUSTOM_PHP_INI 
"/var/www/vhosts/system/rct.dev.bbntimes.com/etc/php.ini"
QUERY_STRING 
""
REDIRECT_BASE 
"/public"
REDIRECT_HTTPS 
"on"
REDIRECT_PASSENGER_COMPILE_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_PASSENGER_DOWNLOAD_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_REDIRECT_HTTPS 
"on"
REDIRECT_REDIRECT_PASSENGER_COMPILE_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_REDIRECT_PASSENGER_DOWNLOAD_NATIVE_SUPPORT_BINARY 
"0"
REDIRECT_REDIRECT_SCRIPT_URI 
"https://rct.dev.bbntimes.com/science/how-to-deliver-value-based-surgical-care"
REDIRECT_REDIRECT_SCRIPT_URL 
"/science/how-to-deliver-value-based-surgical-care"
REDIRECT_REDIRECT_SSL_TLS_SNI 
"rct.dev.bbntimes.com"
REDIRECT_REDIRECT_STATUS 
"200"
REDIRECT_REDIRECT_UNIQUE_ID 
"Z7mRI5DyWLT8YV1VjBpB0AAAAI0"
REDIRECT_SCRIPT_URI 
"https://rct.dev.bbntimes.com/science/how-to-deliver-value-based-surgical-care"
REDIRECT_SCRIPT_URL 
"/science/how-to-deliver-value-based-surgical-care"
REDIRECT_SSL_TLS_SNI 
"rct.dev.bbntimes.com"
REDIRECT_STATUS 
"200"
REDIRECT_UNIQUE_ID 
"Z7mRI5DyWLT8YV1VjBpB0AAAAI0"
REDIRECT_URL 
"/public/science/how-to-deliver-value-based-surgical-care"
REMOTE_ADDR 
"18.191.62.45"
REMOTE_PORT 
"1613"
REQUEST_METHOD 
"GET"
REQUEST_SCHEME 
"https"
REQUEST_TIME 
1740214563
REQUEST_TIME_FLOAT 
1740214563.9732
REQUEST_URI 
"/science/how-to-deliver-value-based-surgical-care"
SCRIPT_FILENAME 
"/var/www/vhosts/dev.bbntimes.com/rct.dev.bbntimes.com/public/index.php"
SCRIPT_NAME 
"/public/index.php"
SCRIPT_URI 
"https://rct.dev.bbntimes.com/science/how-to-deliver-value-based-surgical-care"
SCRIPT_URL 
"/science/how-to-deliver-value-based-surgical-care"
SERVER_ADDR 
"5.196.1.209"
SERVER_ADMIN 
"[no address given]"
SERVER_NAME 
"rct.dev.bbntimes.com"
SERVER_PORT 
"443"
SERVER_PROTOCOL 
"HTTP/1.1"
SERVER_SIGNATURE 
"<address>Apache Server at rct.dev.bbntimes.com Port 443</address>\n"
SERVER_SOFTWARE 
"Apache"
SSL_TLS_SNI 
"rct.dev.bbntimes.com"
SYMFONY_DOTENV_VARS 
"APP_ENV,APP_SECRET,DATABASE_URL,MARIADB_PASSWORD,CORS_ALLOW_ORIGIN,MAILER_DSN,GOOGLE_RECAPTCHA_SECRET_KEY,GOOGLE_RECAPTCHA_SITE_KEY"
UNIQUE_ID 
"Z7mRI5DyWLT8YV1VjBpB0AAAAI0"

Sub Requests 5

CookieController :: renderAnalysis (token = 55441f)

Key Value
_controller 
"App\Controller\CookieController::renderAnalysis"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"ee6da7"

AppController :: renderHeader (token = 1d1dc4)

Key Value
_controller 
"App\Controller\AppController::renderHeader"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"dc21e2"
slug 
"home"

ArticleController :: trendingArticle (token = 6863a9)

Key Value
_controller 
"App\Controller\ArticleController::trendingArticle"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"288644"
category 
"Science"

ArticleController :: relatedArticles (token = 7a1f74)

Key Value
_controller 
"App\Controller\ArticleController::relatedArticles"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"1d0ae1"
current_article 
App\Entity\Article {#1094
  -id: 1282
  -title: "How to Deliver Value Based Surgical Care"
  -slug: "how-to-deliver-value-based-surgical-care"
  -introtext: "<p class="p1">Migrating fee for service care to value based care is an ongoing promise and process.&nbsp;</p>\r\n"
  -content: """
    \r\n
    <p class="p1">The United States stands at a crossroads as it struggles with how to pay for health care. The fee-for-service system, the dominant payment model in the U.S. and many other countries, is now widely recognized as perhaps the single biggest obstacle to improving health care delivery.&nbsp;<span class="s1">Experts have described the pros and cons of whether capitation or value based care should replace fee for service.</span></p>\r\n
    <p class="p1">Delivering value based surgical care takes using data to measure the 12 Cs: compliance, conversion, communication, care coordination and accurate cost analysis and pricing, continuous value and behavior improvement and continuity of care and information, consistency in operations, cash to generate profitable growth, caring about patient outcomes and experience above profits, converting data to information and a viable business model canvas.</p>\r\n
    <p class="p1">Value based surgical care promises to deliver higher quality at the same cost or , preferably, higher quality at a lower cost. Delivering on that promise means that patient teams, surgical care teams and third party intermediaries all have to execute on the 10Cs:</p>\r\n
    <p class="p1">1)&nbsp;Compliance with quality standards&nbsp;established by reputable and valid third parties.</p>\r\n
    <p class="p1">2)&nbsp;Conversion of patients&nbsp;from potential patients to actual patients along the care pathway and continuum without referral leaks or dropped handoffs.</p>\r\n
    <p class="p1">3)&nbsp;Communication&nbsp;between the surgical team, both internally and externally, referral sources and the patient team.</p>\r\n
    <p class="p1">4)&nbsp;Care coordination, particularly with patients who have co-morbid conditions, complications or specific needs.</p>\r\n
    <p class="p1">5)&nbsp;Cost accounting, coding, coverage and pricing&nbsp;that is fair, transparent and accurate. An increasingly important decision is who is responsible for paying for which services during a prescribed episode of care. In addition, more precise coding and documentation needs to be compliant with contract requirements.</p>\r\n
    <p class="p1">6)&nbsp;Continuous value and&nbsp;<span class="s1"><b>behavioral improvement</b></span><b>&nbsp;</b>based on metrics, analytics and feedback to our care partners.</p>\r\n
    <p class="p1">7)&nbsp;Continuity of care and information&nbsp;which means that surgeons and referral clinicians need to be sure there are adequate pre and post handoff arrangements, particularly for those patients who are traveling away from home for care.</p>\r\n
    <p class="p1">8)&nbsp;Consistency in operations&nbsp;that is difficult given the required hand offs from one department to the next.</p>\r\n
    <p class="p1">9)&nbsp;Cash&nbsp;to seed and grow a sustainable business model.</p>\r\n
    <p class="p1">10)&nbsp;Caring about patient outcomes and experience above profitability&nbsp;when there are significant financial performance pressures that can place the ethics of medicine in conflict with the ethics or business.</p>\r\n
    <p class="p2"><span class="s2">11)&nbsp;<b>Converting data to actionable information using analytics</b></span></p>\r\n
    <p class="p1">12) A repeatable and scalable business model&nbsp;canvas</p>\r\n
    <p class="p1">Two critical component of executing on these KPIs is surgeon network engagement and data driven decision making using analytics. In essence, sick care companies, more and more, are becoming data companies that happen to take care of patients.&nbsp;<span class="s1">Building that environment requires four essential ingredients</span><a href="http://catalyst.nejm.org/four-ingredients-independent-physician-network/?utm_campaign=Connect%20Weekly&amp;utm_source=hs_email&amp;utm_medium=email&amp;utm_content=56762909&amp;_hsenc=p2ANqtz--TMr0b_kuxRe9WI98KXTETKyfgdqjGDFDxO_CYerTIjwuX23IL-etvYKpC4J5AdMXSaiwiEC5okGripyCZnyjKOriy2A&amp;_hsmi=56762909" target="_blank" rel="noopener"><span class="s1">:</span></a>&nbsp;Culture, Trust, Decision-Making,&nbsp;and&nbsp;Local Infrastructure. Until the right environment exists, even the most basic request for change will be shot down.</p>\r\n
    <p class="p1">While many of these tasks are increasingly being solved with technology, like telemedicine, and data analytics techniques like artificial intelligence, they can only be completely solved by person to person interaction that is patient centric.</p>\r\n
    <p class="p1">Consequently,&nbsp;<span class="s1">value based care requires care coordination and communication, risk stratification, patient centricity and managing risk</span><a href="https://www.linkedin.com/pulse/ai-field-notes-arlen-meyers-md-mba" target="_blank" rel="noopener"><span class="s1">.</span></a>&nbsp;For those used to practicing fee for service, they will need to learn new skills and create new systems to deliver value.</p>
    """
  -user: Proxies\__CG__\App\Entity\User {#1092 …}
  -createdAt: DateTime @1521188352 {#1145
    date: 2018-03-16 08:19:12.0 UTC (+00:00)
  }
  -updatedAt: DateTime @1621358221 {#1150
    date: 2021-05-18 17:17:01.0 UTC (+00:00)
  }
  -deletedAt: null
  -category: App\Entity\Category {#445 …}
  -status: "published"
  -imageCard: Proxies\__CG__\App\Entity\File {#1184 …}
  -ImageHeader: Proxies\__CG__\App\Entity\File {#1184 …}
  -featured: false
  -mainView: false
  -clicks: 2965
  -comments: Doctrine\ORM\PersistentCollection {#1125 …}
  -reviewed_at: DateTime @1521188354 {#1148
    date: 2018-03-16 08:19:14.0 UTC (+00:00)
  }
  -metakey: ""
  -metadesc: ""
  -robots: null
  -publishedAt: DateTime @1521188354 {#1147
    date: 2018-03-16 08:19:14.0 UTC (+00:00)
  }
  -canonical: null
  -superTag: null
}

CookieController :: renderCookie (token = 038cac)

Key Value
_controller 
"App\Controller\CookieController::renderCookie"
_format 
"html"
_locale 
"en"
_stopwatch_token 
"4dfe68"