The term “value-based care” has become synonymous with change in healthcare in recent years. While the idea behind the model has long roots in American healthcare, the iterations we now see have complex evolutions and require adaptive responses from all levels of the healthcare industry.
Healthcare is undergoing systemic changes driven by an explosion of data, artificial intelligence (AI), natural language processing (NLP) and automation. Organizations are encouraged to collect, analyze and track patient data; identify gaps in care; and find improvements in care delivery. At its core, value-based care is most effective when data shapes informed decisions.
Evolving value-based care
In this ever-changing market, payers, providers and governments are all trying to identify new and innovative ways to deliver the highest quality care, in the appropriate care setting, at the lowest possible cost, all while successfully managing a population’s health and chronic care needs. Much of this work shifts the focus from sick care to preventative and post-discharge care, closing the continuum for patients and promoting the triple aim: improving the healthcare experience, focusing on population health and reducing the cost of care.
One of the most recent developments is the CMS Innovation Center’s Strategy Refresh. The paper announced a “bold new strategy with the goal of achieving equitable outcomes through high-quality, affordable, person-centered care.” Their vision and strategic objectives consist of a ten-year strategy comprised of five pillars for Medicare, Medicaid and Children’s Health Insurance Program (CHIP) recipients:
- Driving Accountable Care: Focus on shift to ACOs or similar models to increase the number of patients in an accountable care relationship.
- Advancing Health Equity: Ensure health equity is present in all models and emphasize care for underserved populations.
- Supporting Innovation: Advance care with data collaboration, technology, education and more innovative solutions.
- Addressing Affordability: Reduce unnecessary or duplicative care costs and address the price of healthcare today.
- Partnering to Achieve System Transformation: Collaborate across all levels of the healthcare ecosystem to enact change.
Given this direction and the current state of the healthcare industry, large-scale changes in contracting strategies and risk-sharing arrangements are likely soon to emerge. These changes must consider the diversity of needs as the industry moves towards population health management. Likewise, healthcare organizations should anticipate an expansion and standardization of quality metrics to determine the value of care delivery. As these models evolve, providers may see incentives around these quality metrics that propel their application in the value-based care environment.
Responding to a new healthcare environment
The current evolution in this space will prove a defining moment in healthcare history, and healthcare organizations must rise to the challenge. TeamHealth embraces the disruptions of traditional clinical and business models. Each day, our teams are rethinking what is possible, using the central question: How do we deliver quality care in the optimal setting, while using enabling technologies that lower the overall cost of managing a population’s health and chronic care needs?
“Navigating this landscape is complex. One could compare it to navigating a climb on Mount Everest. While you can certainly climb it alone, we all can agree that climbing it with someone knowledgeable about the terrain and potential obstacles will likely lead to a more enjoyable and successful journey. That is why it is so important to have a partner like TeamHealth and our value-based care team hiking alongside. Our team has the experience and knowledge to help you and your team successfully reach the summit,” says Ray Cornelio, PhD, MBA, vice president of business development.
To leverage the current market resources, we are exploring strategic partnerships with other healthcare organizations that share our values and systematically incorporating technological advances in digital health and data analytics into our daily practice. Our approach ensures that we are all mutually aligned to streamline clinical pathways, reduce costs, increase patient satisfaction and improve the overall quality of care.
Finding the right partner to evolve
TeamHealth’s long-standing history in hospital-based care means we have pre-built solutions and resources to evolve alongside the industry – responding to necessary growth and headwinds alike. Our teams have the partnerships and expertise to gather data and build programs that align with the needs of our partners and patients. To learn more and connect with our team, please reach out to us.