Moving Value-Based Care Forward

Before the pandemic, change in healthcare could take years, if not decades. But many trends, including value-based care and care management programs, accelerated last year at a record pace because of COVID-19. As we begin to approach a post-pandemic world, how can we maintain this new speed?

As Stephanie Davis, Managing Director of Healthcare Technology and Distribution at SVB Leerink, pointed out while moderating a recent HLTH panel, the topics of data interoperability and value-based care are often viewed as crucial to the future of healthcare, but they're rarely brought up in the same breath.

Surescripts CEO Tom Skelton, Aledade Co-Founder and CEO Farzad Mostashari, MD, and Geisinger Executive Vice President and Chief Innovation Officer Karen Murphy, Ph.D., RN, offered their perspectives about why information sharing is an important part of value-based care efforts.

Information Sharing

In the U.S. today, an aging population and increasing rates of chronic conditions all but guarantee a continued rise in healthcare costs. And when patient data is, siloed out of reach or out of sight, the everyday work of care management becomes slow and costly.

"In the past, information was asymmetrical," Murphy explained. "The payer would have a whole host of information, but the provider would only have their information. If we are going to be successful in managing total cost of care, we all need to see payer, provider, clinical and financial data."

A 2018 Healthcare Financial Management Association survey found that roughly sixty percent of healthcare executives thought their organizations are just "somewhat capable" of interoperability and external interoperability. And 53% of healthcare executives believe their organizations were "somewhat capable" of real-time data access.

Interoperability allows care teams to understand their patients and populations better, so they spend less time tracking down information and staying focused on ensuring appropriate, timely and cost-effective care.

The Consumer Voice is Growing

Panelists agreed that the consumer's voice is growing. Specifically, patients increasingly expect to have access to their medical data and know the costs of medications, procedures, office visits and more ahead of time. "I don't think there's any question that the voice of the populace hasn't been fully heard here yet and will be heard as we continue this journey," Skelton said. "They want the convenience of having that data move. But they also want the comfort of knowing it's moving for their benefit, not for the benefit of other people in the system."

Mostashari, agreed. "We're ahead of the patient on this from the regulatory and policy side, but I do see it as like the sword that cuts the Gordian knot of interoperability: if the patient asked for it, everyone's going to give it to them. We need ways of collecting that information and putting it to use for the patient, so they have a reason to ask for it."

New research published in MIS Quarterly found that meaningful patient portal use resulted in fewer hospitalizations, less emergency department visits and lower readmission rates. Plus, patients who frequently used the patient portal had shorter readmissions than those who did not regularly use the patient portal.

By adopting health IT tools, technology vendors can help their customers stop tracking down clinical and medication history data the hard way. And when customers have access to critical clinical data at the point of care, during care transitions and between patient encounters, it helps them avoid costly—but common—gaps in care.

Regulation Can be Helpful

Murphy pointed out the importance of regulation and how its standardization can make sure that we're going about interoperability appropriately. But Murphy cautioned it being the end-all solution. "Every time you add another regulation, you're adding a cost to the system because of administrative burdens," she explained. "So I believe in regulation where it makes sense, but let's look at its totality and make sure that our eyes are on where we're trying to go: improving care delivery and patient experience."

As Skelton pointed out, the journey to care management is inevitable. "I don't think there's any question that they're moving in tandem, and they're feeding on one another. The journey itself is inevitable. It's just a question of when and how we get there."

Here at Surescripts, our job is to help care teams gain a clearer picture of their patients and populations, so they spend less time tracking down information and stay focused on ensuring appropriate, timely and cost-effective care. Not only does this support our providers on the front lines, it meets the needs of patients looking for better healthcare experiences.