Value-Based Care Gains Traction During COVID-19

Value-based care has been on the horizon for years. Providers that were ready to leverage digital tools to deliver care remotely experienced success when the payment model finally took hold during the early days of the pandemic.

“When we look at the pandemic and how hospitals performed financially, it’s those hospitals that had already started to take on value-based payments that did pretty well during COVID-19, particularly the first six months of last year. And those hospitals that were working on fee-for-service or largely based on volume – the old-fashioned way – did really poorly,” said Jane Sarasohn-Kahn, Health Economist and founder of THINK-Health, a consulting firm based in the Philadelphia area.

To succeed under the financial model, which links payment to outcomes achieved, hospitals need to move away from the long-held practice of tying reimbursements to the delivery of individual services and, instead, effectively manage entire courses of treatment. As such, many providers are relying on virtual tools to deliver the best care, while also conserving resources and streamlining labor.

The “trick” for hospitals, however, rests in determining how to best “bring virtual care into the workflow of an episode of care,” Sarasohn-Kahn said. For example, to successfully manage chronic heart failure patients, providers need to optimally leverage virtual tools such as WiFi scales or Bluetooth-enabled blood pressure cuffs to provide data to health coaches, who then work remotely with home-based patients to achieve desired outcomes.

“When we can start to populate the home with these devices, get data ‘liquid’ and move it where it needs to go,” then healthcare providers “can start to actually conserve costs,” Sarasohn-Kahn pointed out.

In addition, healthcare organizations need to “bring the patient more into owning their healthcare, being a co-creator of health with their physician or with their health system. So the home becomes part of the continuum of care,” and providers can support people in the home with everything “from wellness and fitness … all the way through to coming out of the hospital and rehabbing,” Sarasohn-Kahn said.

A pandemic push

With COVID-19 providing additional incentive to remotely care for patients, leading organizations have more fully embraced virtual tools that can bring success under value-based care. Mayo Clinic and Kaiser Permanente, for example, invested about $100 million into a company that offers a technology platform that enables providers to address acute clinical conditions in a patient’s home.

“We cut our teeth on this in the pandemic. The pandemic really has accelerated this hospital to home movement,” Sarasohn-Kahn said.

Success, however, is not guaranteed. To leverage the potential of virtual technologies, hospitals need an information technology infrastructure that provides a 360-degree view of each patient. To create this, data needs to be tied together using APIs and Fast Healthcare Interoperability Resources (FHIR) standards.

“The underpinning of the health information system” needs to safely “move data from place to place” and enable healthcare managers to access information when needed, Sarasohn-Kahn pointed out.

In addition, as more care moves to the home, leaders need to rethink their business models overall. “We have to start thinking the unthinkable … looking at a future of a hospital without beds, or with 50% fewer beds. How do you then figure out your financial model based on half of the number of beds you have now? I believe it can be done, but it’s a whole different business model and proposition,” Sarasohn-Kahn concluded.

To watch the entire interview with Sarasohn-Kahn and learn how virtual technologies can help providers succeed under value-based care models, visit HIMSS TV/Ontrak3.

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