By Josh Hetler
The COVID-19 pandemic has left many hospitals and private physician practices struggling financially, and underscored what academic and health policy experts have said about fee-for-service (FFS): it is inefficient and incentivizes providers to do more than necessary to increase revenue.
The FFS model rewards the most expensive interventions, at the cost of preventive care, behavioral health services and disease management. What’s more, FFS fosters a siloed health care system that cannot support care coordination across providers.
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The pandemic has also compromised quality reporting and HEDIS measurement reporting, demonstrating how the current approach to quality and safety measures remains too labor intensive, often causing substantial data delays and lacking sufficient standardization to allow for rapid data sharing. All of these factors have prompted a shift toward value-based care.
To help with this shift and offset potential profit decline, stakeholders should consider partnering with a healthcare technology company that offers expertise in population health and experience in empowering better outcomes using real-time data aggregation, EHR and health information exchange (HIE) connectivity and quality reporting through dynamic data visualization.
A clinical data connectivity solution can improve operational performance, care delivery and patient outcomes so that providers can effectively measure the quality of care they are providing. As payers focus more on the cost and impact on population health and assume accountability for delivering better patient outcomes at a lower overall price, stakeholder alignment will become that much more critical in the expanding value-based care environment.
Improving quality measurement and reporting
For providers, adopting effective tools can help them to identify care gaps, access data that informs clinical decisions, improve quality and risk adjustment scores and enhance patient outcomes. In recent months, however, the data required for understanding the quality of the care being delivered to patients during this pandemic has been largely absent.
In fact, the current approach to quality measurement has caused substantial data delays and lacks sufficient standardization to allow for rapid data sharing. Payers need to have the ability to systematically collect information from providers or patients to effectively assess the quality of care provided to improve performance, treatment outcomes and efficiency.