The many-to-many nature of relationships that govern movement of funds, data exchange and patient episode tracking in VBC networks allow providers tremendous flexibility. Providers can participate in VBC programs as individuals, as part of groups, across multiple locations, and across different payer programs and networks. The lack of flexibility and interoperability inherent in healthcare organization legacy infrastructures, in contrast, prohibits the implementation and ability to scale VBC programs.
There is a way to provide the capabilities to support VBC networks without a “rip and replace” of legacy infrastructure, thus serving existing technical debt. By deploying a purpose-built, cloud-based VBC platform that can be implemented as SaaS (Software as a Service), PaaS (Platform as a Service) or DaaS (Data as a Service), healthcare organizations can help fill performance gaps and ease the transition to VBC from the other models.
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An incremental implementation approach facilitated by such a platform enables organizations to build out value-based programs step by step and lay the groundwork for generating the clear insights and quality measures needed for VBC success.
Concerns about complexity
Trepidation among healthcare IT leaders about managing the type of complex, hierarchical “many-to-many” networks necessary to support VBC is another major obstacle to the implementation of value-based models. Their concerns are understandable given that attempts to accommodate the complexity of value-based contracts through a legacy infrastructure won’t scale. Further, they will require lots of manual processing and manpower, which is time consuming, costly and error prone.
Traditional approaches and legacy systems also lack the capacity to scale the orchestration of cascading payment models, under which payer-provider collaborations incorporate risk-bearing entities and downstream participating providers. This reduces the ability of providers to accelerate adoption of varied alternative payment models.
A cloud-based microservices platform avoids these legacy limitations by facilitating easy onboarding of stakeholders and providing mechanisms to financially reward them for their roles. Such mechanisms make the administration of funding pools and data exchange to participating partners among the most important functions of a value-based network.
Conclusion
VBC adoption continues to be held back by concerns that 1) such a change must involve an expensive rip and replace of legacy infrastructure and 2) the complexities of VBC would overwhelm IT staff and resources. But running a cloud-based microservices platform on top of legacy systems allows provider organizations to create a data architecture that will help them participate in VBC networks that result in improved patient outcomes and reduced costs.
About the author: Lynn Carroll is the chief operating officer of HSBlox, which assists healthcare stakeholders at the intersection of value-based care and precision health with a secure, information-rich approach to event-based, patient-centric digital healthcare processes – empowering whole health in traditional care settings, the home and in the community.
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