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What health IT’s past teaches us about value-based care’s future

By Brett Furst

The story of value-based care so far has featured more talk than action, but that could soon change.

Most healthcare organizations are proceeding cautiously toward the value-based future, with many value-based reimbursement (VBR) programs still in the pilot stage, focused on one specific target: an episode of care, a certain cohort of patients, or one medical condition.
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For example, a survey of 89 large physician practices late last year found that just 54 percent were participating in risk-based payment models at all, according to Sage Growth Partners. More tellingly, just 5 to 10 percent of revenues, on average, are tied to risk-based models among participating organizations, which illustrates the high levels of caution with which most in the healthcare community are approaching VBR.

Certainly, a number of these early forays into VBR have revealed its potential to lower healthcare costs while maintaining quality by delivering on the key promise of VBR: the alignment of all key care delivery participants’ financial incentives around similar cost and quality objectives. However, too many of these pilots simply aren’t broadly scalable across disparate healthcare organizations because they’re essentially held together by brute force – manual processes and cobbled-together technologies.

For value-based care to reach the “tipping point” that many expect in 2020, healthcare organizations will need to improve their ability to scale up VBR programs to include more patients and providers.

Before looking forward to the value-based future, however, healthcare organizations would be wise to look back at the recent past for other health information technology initiatives – such as health information exchanges, patient registries and regional extension centers – that present the following key lessons on how to successfully scale VBR programs.

Prioritize interoperability to facilitate data-sharing: A health information exchange (HIE) can be thought of as a network of networks, generally created by providers, to enable data-sharing across a number of different organizations, often those in geographic proximity. HIEs make it easier for providers to exchange protected health information to improve care delivery and point-of-care decision-making.

One essential function of HIEs is to address the well-documented problem of health information technology interoperability. Many healthcare organizations use different technologies with different capabilities that require data mapping and manipulation to achieve a consistent back-and-forth flow of information. HIEs solve this problem by enabling information to be shared more easily.
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