Want Value? Start with What You Know

It’s tough to read about today’s health care problems — and the need to fix them — without coming across the phrase “value-based care.”

Value-based care is supposed to describe real innovations that maintain or improve the health of people and populations while containing costs, or even reducing them. And it’s supposed to do that by focusing on people — their health, lives and priorities — in ways that keep them from getting sick or help them get well as fast as possible.

Unfortunately, value-based care is sometimes a lot more advertising than innovation.

You must be shocked.

There are many factors — such as bad or incomplete data — that make it hard for organizations to implement real value-based improvements. This Modern Healthcare piece explores a lot of them. It’s behind a paywall, but here’s the gist:

So far, the transition to value-based care and reimbursement is happening largely in name only.

While the number of value-based payment arrangements between payers and providers may be soaring, many of these relationships are structured in such a way that the incentive to improve health is not all that great. ...

Inaccurate and incomplete data are the biggest challenges providers face when entering into value-based payment contracts and that discourages them from taking on downside risk.

Data analysis is an essential part of a value-based payment arrangement, offering providers a deeper understanding of their patients including all the interactions they’ve had with the healthcare system. Additionally, data are used to determine improvement on performance metrics. ...

Insurers can’t offer all the information to providers regarding pricing information due to privacy agreements with other provider networks. “That is absolutely frustrating at times,” said Dr. Christopher Crow, president of Texas-based Catalyst Health Network [and CEO of StratiFi Health]. Crow said sections of data reports from insurers are left blank because they can’t disclose the total cost of care for services at certain organizations.

At StratiFi Health, we’re proud of our work helping organizations implement real value-based care improvements. Data is the coin of the realm for us — our model is built around the savings we create for employers.

As our CEO, Dr. Crow, says in the article, the more we know, the more we can improve, and the more savings we can create. For instance, as the story notes, we’ve saved $28 million over two years just through our relationship with UnitedHealthcare.

We’re excited to be on the leading edge of this movement to transform healthcare by gathering all of the information we can and putting it in the hands of patients and their physicians. Those kinds of 21st century innovations are what will really create value-based care for patients and help communities thrive.