“The report of my death was an exaggeration.”
This often-misquoted Mark Twain quip not only continues to cement the author’s reputation as one of the wittiest humans to ever walk the planet. It’s also the perfect descriptor for the state of value-based healthcare today.
Over the last year or so there has been a great deal of uncertainty around the future of value-based care. Organizations that had made tremendous investments in technologies such as electronic health records (EHR) and population health management worried that the money they’d spent might turn out to be wasted. The cancellation of two alternative payment models and reduction in the scope of a third by the Centers for Medicare and Medicaid Services (CMS), and rumors about other changes, didn’t help that perception.
But like Twain, the reports of the demise of value-based care appear to be premature. In fact, it seems like healthcare as an industry has embraced the transition away from the traditional fee-for-service model not only as a result of government mandates but because it’s the right thing to do.
Following are four key trends that demonstrate value-based care is still alive and kicking—and is actually thriving.
Consumer (patient) demand is growing
For most of modern healthcare, patients were essentially spectators in their own care. Various providers would deliver services individually, with very little coordination between them. No one seemed to be looking at the big picture of what types of outcomes all this fragmented care was achieving, and the patients themselves were content to bob along like corks on this particular ocean.
Not anymore. At the end of the day, patients are consumers, and consumers overall have greatly increased their expectations regarding services being provided. The Internet has given them more insights and control over their buying experience, and that newfound power has spilled over into healthcare.
Today’s patients want to be informed, and expect that every provider they see has insights into their longitudinal records. They don’t view the physician’s job as simply treating them when they’re sick or injured. They want their physicians to help them stay healthy to improve their quality of life and reduce the cost, pain, and inconvenience that come with being sick or injured.
To address these expectations, providers and health plans are creating partnerships that lead to tighter integration and more sharing of data, creating a better-coordinated and ultimately more satisfying consumer experience.
EHRs are being re-invigorated
One of the cornerstones of the shift to value-based care was the mandatory implementation of EHRs by hospitals, health systems, and medical practices. Yet rather than achieving their potential as a means to improve and expedite care, their rigid constructs around data entry and workflows that differed significantly from the way healthcare professionals were used to working acted as hindrances rather than helps. Even the concept of being able to share data easily between providers in order to improve care coordination was lost in a sea of proprietary, mutually exclusive technologies.
That is now changing. Natural language processing, machine learning, and artificial intelligence have the potential to significantly improve not just the way data is captured but also the interpretation, understanding, and usefulness of the information being documented in the EHR as well as other systems. Advances in these areas are helping providers take those technologies from mere record repositories to valuable sources of information. They are helping to unlock the potential of EHRs and other systems, helping providers achieve a far greater clinical and financial return on their technology investments.
Use of virtual care is exploding
One of the challenges of holding providers accountable for outcomes has been what happens once the patient leaves the hospital or office. For example, a patient may do well in a hospital, where his or her condition is being monitored 24/7 and any problems can be addressed instantly. But once he or she leaves that setting, conditions can quickly deteriorate, especially if the patient doesn’t follow the instructions that were provided at discharge.
This issue is being addressed by enhanced utilization of emerging technologies such as telemonitoring. Rather than waiting for the patient to feel sick enough to return to the physician’s office (or emergency department), telemonitoring enables quality care to be moved to the home. If a patient’s condition falls below pre-set parameters, healthcare professionals are alerted so actions can be taken to correct it, before a hospital or office visit is required.
These technologies also enable an enhanced primary care experience that combines virtual and in-office visits. That’s particularly valuable for elderly or other patients who have difficulties traveling, as well as for those living in more remote areas.
In many cases, companies providing these capabilities are bypassing health plans entirely and bringing their services directly to employers who see the benefits of keeping employees (and their families) healthy. As it grows, this approach could have a significant impact on care delivery, and will certainly help ease the transition to value-based care.
A focus on results
While much of the concern over the past year has been about government regulations, the real determinant of whether value-based care will become the norm is the consumers. They don’t care how we get there. They care about the health and cost reduction results we achieve.
This is an area where drug companies have had some missteps. Some have implemented “value-based care” programs to say they did it rather than having real, tangible outcomes in mind. Fortunately, that is now changing.
The more everyone in healthcare can demonstrate clinical and financial improvements in hard data, the smoother the transition will be.
Going strong
Given looming physician and nurse shortages, making the transition to value-based care isn’t just a lofty, abstract goal. It’s a practical solution as well.
So, while it’s good to be concerned about the overall direction, rest assured that reports of the impending demise of value-based care are not just exaggerated. They’re contrary to what’s really happening in healthcare.
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