Industry Insights

Part Five - Using Accurate Data to Improve Value-Based Care

Previous: Four - Implementing Accurate Data to Drive Price Transparency

Transcribed Video Content Below

All right, so moving on from pricing transparency. We talked about contract governance, and then we talked about how to leverage that information within the negotiation process, then we talked about pricing transparency and what it means today. Lastly, we're going to talk about value-based care and population health management, and what that really means. And as we talk about population health, what we're really talking about is really preparing for the shift. We can all agree...I think I said this earlier that we're not sure where population health and value-based care is going, but we can all agree that it's coming and the industry is moving that way. And the question just becomes, when is it going to happen? So we need to get the data and the analytical structure in place now. So as you elect or get forced into value-based care contracts, you have the ability to make educated decisions that won't put your organization's financial stability in jeopardy.

So as finance professionals, we're going to need to start better understanding the clinical triggers and performance-based metrics that we will be graded on. We will then need to understand the financial impact of those metrics and benchmarks if we don't meet them.

Today, two of the most basic performance metrics that we use are readmissions and average length of stay. And actually, now, we're thinking about it or when you really think about it, this is a readmission slide, but another way to leverage this type of analytics is to do more of a comparative analysis and begin comparing what estimates are being pushed out and what services are actually being performed. Understanding these deviations will help you increase the accuracy of your estimate process, but it will also allow you to better understand some of the unknowns today of what patients are shopping, what services they’re shopping for, and what care they are eventually scheduling. Getting creative with these analytics will help us gain a whole lot more insights into our market that we may not know today.

So lastly, we'll need to understand the population dynamics that exist across our markets and payers in order to effectively understand the real value attributed to the value-based contracts. We will need to understand what population is paying by what payer so that we can really understand the clinical outcome piece of it, and how it affects each of our different populations.

So in summary, we really need to start moving more towards an integrated revenue strategy to make sure that we're driving revenue across our organizations. What we've seen is that, when organizations begin to leverage these historically siloed departments and leverage all of the information together, they can really start seeing some dramatic impacts on their net revenue and some dramatic increases, especially when you do it on the hospital side, technical side, as well as the professional side together. Leveraging all of this together is where you really start to see the impact.

So, and we talk about, the key takeaways. Key takeaways would be making sure that your data is accurate, breaking down the silos, and then lastly, preparing now for the consumerism and outcome-based care that's coming down the road.