The Institute for Health Technology Transformation (iHT2) released a report recently that beautifully summarizes the IT challenges of value-based healthcare reimbursement. Sub-titled “Building an Infrastructure for Financial Risk,” the report calmly outlines the enormous transformations that are needed in healthcare IT to support a reimbursement framework that transfers financial risk from the payer to the healthcare provider.
The bad news: healthcare IT is no longer just about record-keeping. It demands all kinds of capabilities that are new to the industry. Managing the financial risks to a healthcare organization and providing a high level of patient care requires (among other capabilities) predictive analytics, effective customer communications, financial modeling, and a delicate balance between automation and human contact.
The good news: many of these techniques and technologies exist in other industries and can be adapted to the healthcare care. Of course, those adaptations won’t all be straightforward.
Twelve key take-aways from the report (read more here):
- Make sure you have enough primary care physicians and other clinicians to provide comprehensive preventive and chronic care
- Restructure physician comp to align provider incentives with value-based care.
- Create patient centered medical homes or use existing PCMHs as building blocks for your ACO.
- Focus on care management for high-risk patients as well as other segments of the population that could become high risk in the future.
- Automate as much of population health management as you can while emphasizing human contact for high-risk patients
- Embed care managers in practices wherever possible to create close relationships with patients.
- Don’t try to manage population health with your EHR alone, but use applications built for population health to help accomplish your goals.
- Integrate claims data with clinical data to provide breadth, timeliness, and adequate detail for analytic purposes.
- Find ways to obtain timely information from hospitals and health plans about admissions, discharges, and procedures
- Use predictive modeling to intervene with patients who are likely to get sick in the coming year.
- Use registries to track patients’ health status and make sure they get the services they need.
- Apply financial analytics to budgeting, using historical data on costs and, if possible, activity-based cost accounting.
Download the full report from iHT2 here.