The shift to value-based care represents one of the biggest challenges faced by healthcare organizations. Meeting the triple aim of improving patient experience and population health while reducing the per capita cost of care will require creating a means to measure costs and quality at the case level as well as at the aggregate level. Supporting technologies must illuminate the relationship between costs, clinical practices and patient outcomes over time.
Current fee-for-service models will not entirely disappear in the transition, at least not for the foreseeable future. As providers move to pay-for-performance models, it is important to understand how current FFS and new quality-based systems can coexist to provide the best patient care while remaining financially viable.
In the effort to reduce cost of care without compromising quality, much can be done in terms of better utilization of assets and resources. Critical to success in value-based care adoption is the use of technologies that enable effective clinical and cost analytics. Evolving technical infrastructure must support:
- Integration of financial and clinical data sets to yield insight into the true cost per patient case, potential gaps in care delivery and related outcomes
- Routine tracking of clinical quality measure performance to support ongoing process improvement and reporting initiatives
- Data-driven care management programs designed to promote at-risk patient identification and intervention and care team collaboration
Technology can support advances in care coordination across a range of care settings. In an environment moving toward episodic care and billing, health organizations need to cater to care episodes that may involve providers that are not part of their organization. In both internal and cross-setting care delivery, health IT must enable process optimization through informed action.
On September 26th, Pivot Point Partner Jon Melling will lead a CHIME focus group to discuss and better understand the technical infrastructure and business processes being implemented by hospital leadership teams.
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