Succeeding in Value-Based Care

The value-based care movement has involved a long list of incentive-based programs, all of which rely on accurate and timely data. There are many ways to collect useful data, of course, but the key word there is “useful.” Making data actionable under value-based care is essential for organizations to survive and succeed in the new world of reporting and reimbursement.

Digital health includes a number of options for collecting data, including electronic health records (EHRs) and wearable technology. In turn, the benefits of these options depend on making data actionable. Using the information collected to improve the quality of care for population health and for providing healthcare that is more efficient, financially, is a critical aspect of value-based care.

The cost and quality of care depend on the ability to act on data collected, particularly as more primary care physicians anticipate that their income will originate in advanced value-based care models, such as a population-based payment arrangement or an accountable care organization (ACO).

A survey conducted in 2018 found that, increasingly, medical groups and integrated delivery systems are replacing their fee-for-service income with revenue they are realizing from bundled payments, ACOs, and Medicare Advantage.

How is data made actionable? There are some basic steps, including:

• Find it. The first step is to use available technology such as EHRs to locate the sources of critical healthcare data.
• Capture it. Although EHRs make data collection virtually automatic in most cases, there is still information that may need to be manually extracted, particularly if a provider continues to use a paper-recording system for patient notes.
• Standardize it. To be consistent and useful, items must have the same format. Think of a simple spreadsheet in which patient names may be listed in their entirety in each cell or separated by first name and last name. If multiple spreadsheets list patient names differently, the data can be ambiguous. Normalizing the data ensures that all of the data is used in the same way and that it is accurate and reliable.
• Consolidate it. Aggregating the data enables providers to analyze the overall impact of the pool of patients, particularly when an organization has quality and cost responsibilities for the entire pool. Compiling and analyzing data provides the opportunity to identify individual patients who affect the risks of the whole group.
• Report it. Value-based care incentive systems require regular and accurate reporting. That will become more integral to quality improvement as other third-party payers follow CMS’s lead.
• Make an effort to understand its impact. Use the data gathered to understand more about what was effective in terms of healthcare delivery and efficient operations – and what was not. Undertaking a root-cause analysis can help the provider and the organization achieve what may seem to be conflicting goals of quality and cost.
• Use the data – make it actionable. The most important function of data is to make it actionable. It should be used to improved processes and outcomes, including financial results and the patient experience. The data must be secure, HIPAA-compliant, and actively managed. Even when data is accurate, it is not useful until it is made actionable, to manage the quality and cost of care.