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Value-Based Care and Care Coordination Go Hand-in-Hand

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October 24, 2019

Value-Based Care and Care Coordination Go Hand-in-Hand

Jennifer Morency

picture Value-Based Care and Care Coordination Go Hand-in-Hand

Value-based care, as much as care coordination, have the goal of reaching collaboration between clinicians, health plans, employers and other important stakeholders. In order to put patients and populations at the forefront, a holistic coordination of the healthcare system as a whole is necessary.

Patient-Centered Model

The focus of value-based care is essentially putting emphasis on the patient’s clinical needs within healthcare establishments as well as within their everyday lives. To understand the impact of all of the aspects that affect a patient’s health journey, a solid model of care coordination is needed to anticipate health needs and work towards a preventive approach to medicine.

Implementing a patient-centered model means putting the patient at the center of their own health system. It means providing them with the tools and resources necessary to not only empower them, but to also promote care coordination through the collaboration and alignment of various stakeholders such as hospitals, clinicians, health plans and more.

This will of course incur significant costs, which means organizations will need to make strategic investments in areas such as:

  • Analytics
  • Population health
  • Training
  • Educative resources
  • IT infrastructures

The technology used within healthcare establishments will also play a factor in the success or demise of establishing a patient-centered model.

The Role of Technology in Care Coordination

What will ultimately support a value-based care model will be the technology and systems implemented. Depending on the sophistication of the systems used, patients will potentially only need to complete their medical history once and have all subsequent clinical data input in one place, updated in real-time and accessible by any healthcare professional within the patient’s care cycle.

The push towards interoperability in the healthcare sector will greatly help the technology used by clinicians. It will also positively contribute to the goals of the value-based care model that include lower costs, improved outcomes, and better-quality care for both patients and doctors.

Leveraging data analytics and relevant software, patients will receive quality care that follows them from the clinical setting to their everyday lives. Linking value-based care with care coordination will require a long-term view on both the patient and provider end, requiring technology such as patient portals and resulting in better coordination and physician and care team empowerment.

Challenges to Value-Based Care

The most challenging aspect of implementing a value-based care model is the cost associated to ensuring healthcare systems have interoperable data and technology. Allowing them to create structures, procedures and terminology that is used across various providers and establishments will lead to effective care coordination. To successfully participate in value-based care, clinicians must first ensure patients are highly involved in their care by providing them educational resources and tools through care coordinators.

As this is more easily said than done, the AAFP and Humana conducted a study on the top barriers to value-based adoption among physicians, with the results being the following:

  • Lack of staff time to implement care functions that support value-based payments
  • Lack of resources to report, validate, and use data
  • Lack of data as it relates to interoperability
  • Lack of standardization of performance measures and metrics
  • Lack of transparency between payers and providers

It is interesting to note that these barriers, first recorded in 2015, were still prevalent in 2017, with only slight differences between the two-year span.

In order to combat these challenges and successfully implement a value-based care model, healthcare systems must ask themselves: what areas can be improved? What kind of programs will make a difference? What data will provide opportunities for improvement in outcomes, care quality and cost across the continuum of care?