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Defining Success in Value-Based Care

October 2, 2019 BY Carisa McLaughlin

Defining Success in Value-Based Care

The implementation of value-based care is a trend that is continuously on the rise and has already begun to transform the healthcare sector. How providers approach delivering care will continue to change, from payment structures and operations to evaluations of services. While there are different ways to employ a value-based care (VBC) system, the ultimate goal is to shift away from the fee-for-service model to one with a greater emphasis on positive patient outcomes.

Recently, Definitive Healthcare hosted the second virtual panel in a webinar series on VBC, with healthcare leaders Dr. Gary Wainer, Susie Valentine, and Dr. Randall Taubman discussing how providers can define success and what metrics they deem essential. As VBC programs become more popular, clinicians and hospital leaders will first need to understand the areas where they can improve most before they can focus on workflow optimization.

The panelists suggested that care providers would likely begin to see changes 3 to 6 months after VBC implementation, when they can start to reflect and improve on the process. The key metrics our panelists focused on were:

  • Quality measures
  • Utilization review of network usage
  • Patient satisfaction scores
  • Cost efficiency data

Healthcare providers will have to address challenges such as how to effectively evaluate their implementations and how to ensure they’re measuring performance metrics that are truly indicative of quality care. Sophisticated analytics can play a key role in augmenting VBC by helping healthcare organizations better understand the intricacies of their operations — providing more transparency into patient outcomes and identifying ways to lower costs while still achieving higher quality of care. 

Most effective analytics for VBC

Analytics technology can provide greater visibility into costs, risks, and patient outcomes. Without proper analytics, successfully implementing VBC programs can feel overwhelming for providers. However, the benefits of conducting regular analyses of VBC implementation are vast. Healthcare analytics can help:

  • Monitor the effectiveness of value-based care strategies 
  • Identify opportunities to reduce cost across the organization
  • Improve clinical and quality scores through historical data tracking
As noted by our panelists, some of the main challenges to implementing value-based care revolved around poor incentive structure, lack of physician buy-in, and ineffective education on the benefits of VBC. However, with analytics tools in place, hospitals and health systems have more sophisticated capabilities to integrate, understand, and properly leverage their data for measuring success before and after implementation.

Planning to succeed in VBC

The key to success in transitioning to a VBC model is internal preparation. It’s vital to take the pulse of how a practice is doing before moving forward, like creating a benchmarking plan to ensure stakeholders understand the specific goals of a care organization. It is also important to convey to clinicians and other stakeholders that it could take several years before VBC programs feel fully integrated into workflows.

Though there appears to be an overwhelming amount of preparation and disruption in transitioning to VBC, this should not discourage healthcare practitioners. Having a CEO or physician champion in place to spearhead the process will be instrumental in advocating for the necessary software analytics, operational tools, and changes in internal processes. This could mean consulting with or hiring a physician leader or other administrative professional who has been through the process before to explain best practices and clearly outline expectations.

The future of VBC

As we blaze forward on the VBC trail, the question will no longer be whether or not to adopt VBC, but how to implement it effectively. It will take a lot of trial-and-error in the coming years to get healthcare organizations where they need to be in providing value-based care. However, with continued support and commitment to improvement, there is a very high chance of leading successful VBC programs that improve both the quality and value of patient care.  

The increasing adoption of value-based healthcare puts even more emphasis on making smarter decisions, mitigating risk, and delivering preventative care. Make sure you understand how your hospital compares by accessing the most reliable healthcare intelligence available through Definitive Healthcare. With Definitive’s comprehensive platform on hospitals and IDNs, you can:

  • Understand facility and network affiliations and referral patterns
  • Identify facility leaders and decision-makers with contact information
  • Analyze current and historical diagnosis and procedure data across facility types
  • Build custom reports of facilities by region, performance metrics, financial data, and other filters

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