Madhur Sharma
Vice President - Product Management
(Author)
Value based care is a healthcare model in which providers are paid based on the value of the care they provide to patients, rather than the quantity of care. The aim of this model is to improve patient outcomes and reduce healthcare costs. Data plays a key role in value-based care as it allows providers to track and measure the quality of care and outcomes for patients. It is also needed to determine how much a provider should be paid. The data may also be used to inform decisions about how to best deliver care and how to allocate resources.
In a value-based care model, primary care providers are responsible for coordinating and managing the care of their patients. This includes providing preventive care, managing chronic conditions, and coordinating care with specialists. Having the ability to access longitudinal patient data, including determinants of health can enable primary care providers identify which treatments and interventions are most effective for a particular patient and use this information to tailor their care plans. This can help improve quality of care as well as reduce waste and inefficiency. Simultaneously, patients can make informed decisions about their care.
Despite being such a critical element, data is still a missing puzzle that is inhibiting healthcare organizations to adopt value-based care models. There are several reasons. One reason is that the healthcare system is complex and fragmented with different providers using different electronic health record (EHR) systems and data sources. This makes it difficult to collect and integrate data from various sources, and to provide a comprehensive view of a patient’s care. Other challenges include:
- Data Aggregation:
- Data Normalization: Data normalization involves organizing data within sets in such a way to make it semantically interoperable and ready for consumption. Overcoming the normalization challenge is a critical need for organizations aiming to provide data-driven, high-quality care at both an individual and population level. That’s because hospitals, health systems, community clinics, and physician practices are increasingly reimbursed and ranked based on patient outcomes.
- Data Sharing: Providers must comply with the new ONC 21st Century Cures Act Information Blocking Final Rule. Healthcare providers and other actors like health information networks or health information exchanges, and health IT developers of certified health IT are obliged to provide accessible, exchangeable, and usable data to patients and authorized health systems. Learn more about the final rule here.
- Data Governance: The practice of managing data assets throughout their lifecycle to ensure that they meet organizational quality and integrity standards is much needed. Data governance enables users to trust their data, which is especially important when making patient care decisions. While the exchange and exploration of large amounts of health data is a source of progress and medical innovation, providers must implement a strong data governance framework that is both people and technology intensive.
- Data Analytics & Reporting: Data reporting is crucial for providers to realize revenue as value-based reimbursements. Health systems under shared risk contracts often lack data on cost and quality measures, they rely on payors for the information, and this inhibits organization’s ability to adjust in real-time. The rapid adoption of value-based care models has put pressure on healthcare organizations to enhance their visibility into the challenges and utilization patterns of their attributed populations to stay ahead of avoidable spending.
US healthcare is fragmented, patient healthcare data is typically spread across multiple disparate systems or data isles that do not talk to each other. Clinical conditions, results, labs, imaging, admission, discharges, or transfer information is often not shared on time with the care teams. The inability to effectively integrate healthcare data creates inefficiencies that lead to burnout, financial losses, and poor health outcomes.
To overcome these challenges and make the most of the potential of data in value-based care, providers need to invest in data platform, and work to remove barriers to the sharing and use of data. By doing so, they can improve the quality and value of care, and better meet the needs of patients.
Contact us to Learn how Minerva’s capabilities can help you to address these challenges.
