The fundamentals of population health management, including patient attribution and risk stratification, will help providers succeed with value-based care.
Healthcare organizations and their payer partners are learning very quickly that the transition from volume to value-based care is significantly more complicated than signing on the dotted line to switch reimbursement rates from one payment model to the other.
The process of embracing pay-for-performance care can be full of uncertainty, requiring a concerted effort – and some degree of trial and error – to develop partnerships, educate staff, engage patients, and implement population health management strategies that result in true improvements to patient outcomes.
At the Fall 2016 Value-Based Care Summit, attendees received a crash-course in the fundamentals of this new approach to delivering quality care, including developing the health IT infrastructure required to move data along the care continuum and the challenges of retooling workflows and other processes to create more efficient, effective organizations.
For Chip Howard, Vice President of Payment Innovation at Humana, strong partnerships across the care continuum are the bedrock upon which value-based care must be built.
Good relationships between providers and payers – and providers and patients – are required to ensure that every stakeholder understands their responsibilities and becomes an active participant in architecting the value-based environment.
“Value-based care is a journey we have to take together,” he told HealthITAnalytics.com. “Under these arrangements, Humana and the payer industry in general will not be successful unless our provider partners are successful.”
“It behooves us all to work together and collaborate to make sure we have the infrastructure in place – and make sure we have the trust and relationships required for these arrangements.”
Since financial risk and incentive opportunities are predicated on well-defined patient outcomes, the first step for providers diving into the value-based ecosystem is to untangle the attribution problem, Howard says.
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