Realizing rapid value in value-based care

Value-based contracts (VBC) offer significant incentives for healthcare organizations willing to adopt change, but to drive meaningful change quickly, organizations need to be laser-focused on improving clinical quality, lower the cost of care, and creating consistently positive member experiences. Sounds pretty easy, right? It’s not. However, with the right pieces in place, organizations can find early success much more quickly and start to prepare their organizations for the rapidly approaching VBC future.

Creating and capturing value with VBC

As the shift from fee-for-service to VBC gains more momentum, there is a clear and urgent need for provider organizations to evolve their traditional service model to a more holistic, patient-centric care setting. To create and capture more value, providers need to foster stronger relationships with patients, physicians, care managers, and any relevant stakeholder. Providers must acknowledge the speed and intensity of this transition to value as patients continue to take more control over their healthcare decisions, and physicians are increasingly required to focus on driving patient satisfaction to strengthen patient loyalty, improve patients’ engagement with their own care, and ultimately, earn better financial incentives.

According to a McKinsey report, taking greater advantage of existing VBC programs can improve most providers’ EBITDA by at least 20%—sometimes up to 50% in low-margin systems.

To deliver a comprehensive and efficient value-based care model, an analytics-powered approach that will break down silos and offer an integrated and agile platform can help organizations deliver on this opportunity. With a sustained focus on risk sharing agreements, organizations can establish a path to long-term savings within a few short years. And by implementing a coordinated care management system, organizations can actively encourage primary care providers to avoid unnecessary emergency visits, streamline workflows, and improve TCM, CCM, RPM, and AWV strategies.

What are TCM, CCM, RPM, and AWV?

1. Transitional care management (TCM) includes post-discharge care as well as comprehensive consultation and management services that increase patient satisfaction, reduce readmissions, minimize cost, and improve outcomes.
2. Patients with chronic conditions require more strategic preventive care and higher care costs. Chronic care management (CCM) services are delivered to Medicare beneficiaries who suffer from two or more chronic conditions expected to last at least 12 months or until the end of the patient’s life. CCM services contribute to better individual health and result in a lower rate of readmissions and ED visits. The services include, a steady relationship with a member of the care team, patient support for chronic diseases to achieve optimum health, 24/7 patient access to care and health information, coordination between patient and provider, and receipt of preventive care. Innovaccer’s tools help providers successfully manage CCM strategies, enabling effective risk management while focusing on chronically ill patients.
3. Remote Patient Monitoring (RPM) includes remote monitoring and tracking of patient health with chronic conditions via telehealth services. This not only enhances the quality of care but also improves clinical efficiency by reducing readmissions and healthcare costs. In addition, telehealth technology can improve the capability of home healthcare and help patients avoid unnecessary ED visits.
4. Annual wellness visits (AWV) are covered by Medicare Part B and create or modify a personalized plan for patients to prevent illness based on current health and risk factors. AWV services close care and coding gaps and improve quality scores and risk adjustment in the long term.

Innovaccer’s solutions for Rapid Value Realization

Enter: the Innovaccer Health Cloud. Designed to help provider organizations realize rapid value, our offering combines Innovaccer’s Data Activation Platform and an extensive application suite of services and tools allowing customers and partners to develop interoperable applications that improve patient engagement and operational performance and reduce the cost of care.

The comprehensive solutions built on the Innovaccer Health Cloud:

• Enhance existing workflows with advanced analytics
• Streamline and aggregate patient data from multiple sources
• Automate scheduling, follow-up, and bulk outreach

With these capabilities, organizations can easily track and manage TCM, CCM, and AWV strategies to derive value from value-based contracts.

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