Renton, Wash.-based Providence is investing in technological infrastructure and patient-centric care to navigate the complexities of value-based care, Semira Singh, director of informatics at the health system, told Becker's.
Providence's network of contracts includes nearly 200 agreements with around 60 payers. But in addition to contracting investments, the health system is investing in data infrastructure.
"When we talk about components of value-based care, like risk adjustment, you want to be able to ensure that you are sharing adequate data with the payers to build that right risk profile," Ms. Singh said. "But what often happens is data codes will get dropped from claims or there might be some sort of discrepancies in the EMR where everything doesn't get sent out or where the clearinghouse doesn't get that information. We have been able to automate processes to share all that data with our Medicare Advantage payers."
By streamlining the exchange of information and ensuring the accuracy of risk profiles, Providence has been able to enhance operational efficiency and unlock cost savings amounting to millions of dollars across each payer, she said.
Additionally, the health system prioritizes the integration of quality measures into its operations, leveraging automated data sharing to uphold contractual obligations. By eliminating these manual data entry tasks and advocating for comprehensive data access, Providence has been able to help its providers to make informed decisions and deliver tailored treatments, leading to enhanced patient outcomes and reductions in the need for redundant services.
The health system is one of the few provider groups leading the pathway towards standards-driven interoperability.
In addition to technological advancements, Providence has been proactive in its efforts to advance value-based care principles.
"We do a lot of advocacy work around ensuring that payers are giving us enrollment data that accurately reflects which members are assigned and attributed to us, as well as which members are part of our clinic population and so forth," Ms. Singh said.
By advocating for transparent data sharing and enrollment accuracy, Providence is working to ensure that providers have the necessary insights to deliver personalized care and navigate the complexities of risk-based contracts effectively.