Value-based health care models are on the rise. In fact, the adoption of value-based care is expected to account for 59 percent of health care payments by 2020, according to Aetna’s 2018 Healthcare Trends. Healthcare data is fueling this revolution — but does your organization have the capabilities needed to keep pace? And how will you gain insight into your clinical and business operations to meet both cost and quality targets?
As vice president of finance and analytics at Beth Israel Deaconess Care Organization, I’ve been on the forefront of healthcare analytics since 2001, and have learned a few lessons on how to help leaders of health systems ease the shift to value-based care.
To support value-based care at an organizationwide level, provider organizations need the following tools, skills and goals to get started and be successful.
Start the Journey to Value-Based Care with the Right Tools
Healthcare IT continues to evolve, and what’s “right” will depend on your organization’s specific needs. However, virtually all organizations will need to focus on solutions that break down silos and aggregate data across various disparate health IT systems and electronic health record platforms.
For example, at BIDCO, a value-based physician and hospital network and accountable care organization in Massachusetts, we aggregate clinical data from across more than 45 different electronic health records systems, as well as claims data, radiology data, scheduling data and lab results. We partner with a vendor and rely on their technical solution to do that work. This technology also helps us identify and stratify patients who would most benefit from BIDCO’s care management programs or other population health initiatives.
Partnership Between Data Analysts and Clinicians Is Vital
With the right tools and the right data analysts, provider organizations will generate important insights. However, those insights will have little value unless they can be put to work. Make it a priority to build partnerships between analysts and population health experts so that communication flows as freely as possible. I meet with BIDCO’s chief medical officer regularly to manage and nurture these relationships and discuss trends materializing in the utilization and cost data within our commercial, Medicare and Medicaid lines of business.
These conversations support the development of programs that contribute to the success of our value-based contracts. Leaders on our teams also meet weekly to dig into the cost drivers and identify areas of opportunity for improvement against efficiency and quality targets.
Foster Provider and Program Accountability
As provider organizations pursue value-based care, be sure to monitor and measure the changes you implement. Establish regular meetings (in-person or remote) with your key stakeholders, physicians and hospital leaders, as well as with the health plans, to keep everyone aligned, report progress and gather feedback.
This opens the lines of communication to help identify and address and barriers to success that may arise. Regular feedback sessions also help in gaining the trust of the physicians and increasing their engagement.
Ensure Leaders Have a Long-Term View of Value-Based Care
The transition to value-based care won’t happen overnight. Chart your course thoughtfully, including shorter-term and long-term goals, and adjust your plans based on the results of your monitoring and measuring. Be sure to achieve buy-in on the vision, so that all stakeholders can recognize the positive impacts of working together toward shared objectives.
In addition to making organizational improvements, the transition to value-based care will require data analysts who can turn aggregated information into actionable insights. Look for IT people who have skills beyond coding or data reporting. Today’s health care data analysts also need to be:
- Big-picture thinkers — Value-based contracts are typically complex, with many potential pathways to success. That’s why health care data analysts can’t be overly granular or technical. Instead, they need to take a more holistic approach, drilling down through layers and understanding how the data they’re working with ties into both the business and patient care.
- Effective communicators — It’s not absolutely necessary for your data analysts to have a health care background. What is crucial, though, is that they gain an understanding of the clinical language and can communicate with providers. Healthcare data analysts can’t just run data and pull reports; they need to mine for insights and then share those findings effectively so that changes can be implemented to drive outcomes. Of course, as I mentioned above, communication is a two-way street, which means data analysts need to be good listeners, too.
- Data visualizers — Healthcare data analysts must be able to present data in meaningful ways. Imagine a room full of providers looking at a report that includes 30 different quality measures. Most would be overwhelmed with all that information and not know how to begin to interpret it or where to focus their efforts. A talented data analyst can synthesize disparate data points and home in on what’s most important, presenting their analysis in a way that’s clear and compelling and provides direction.
- Adaptable — Value-based contracts are not one-size-fits-all. As a result, health care data analysts need to be able to customize metrics and targets and adapt to changes within care communities. They need to stay curious, continuing to look for new ways to synthesize data and use it to create value.
Making the transition to value-based care will likely mean you’ll need new capabilities in both systems and talent. But the effort will be worthwhile. Using data analytics to gain actionable insights into your clinical and administrative operations will enable you to improve patient care and identify opportunities for continued business success.