The CMS and Healthcare Transformation Task Force recently announced the rapid acceleration of value-based health care:
A group of the nation’s largest healthcare systems and payers, together with purchaser and patient stakeholders, have announced the creation of a new private-sector alliance dedicated to accelerating the shift to value-based business and clinical models in the U.S. healthcare system that are aligned with improving outcomes and lowering costs. Called the Healthcare Transformation Task Force, the alliance includes six of the nation’s top 15 health systems and four of the top 25 health insurers. The Task Force has issued a challenge to providers and payers to put 75 percent of their business into value-based arrangements that emphasize better health, better care, and lower costs by 2020 1
According to new federal guidelines, the U.S. Department of Health and Human Services wants 50 percent of all ACO payments and 90 percent of all traditional Medicare payments tied to quality or value by 2018. 2
For healthcare providers, now is the time to assess their information systems infrastructure in relation to supporting value-based healthcare.
As a starting point, value-based healthcare will require core information systems functionality addressing four key areas: – data exchange interoperability, advanced population health analytics, community care coordination, and patient empowerment.
- Data Exchange Interoperability– the ability to support real time data exchange interoperability between multiple organizations and systems. Integrating information and workflows across EHRs, care teams, providers, community resources and health information exchanges (HIEs) with a reliable and robust master patient index system.
- Advanced population health analytics – the ability to support three levels of analytics: descriptive, predictive, and prescriptive for population health management and accountable care for improving population health outcomes.
- Community care coordination systems – the ability to support automated workflows and closed loop referrals with community partners engaged with your member/patient population. This includes the use of built-in rule engines that can trigger alerts and manage interventions, and can support the ability to systematically manage health pathways for members/patients – particularly those with multiple chronic illnesses.
- Patient empowerment systems – the ability to interact with members orpatients beyond simple portals, to include automated interfaces with phone apps and personal health monitoring devices. It also works to support members or patients in their self-care responsibilities, prescription drug adherence, lifestyle improvement and wellness programs.
Existing Electronic Medical Record (EMR) systems may be able to provide basic reporting on some of the value-based healthcare quality measures, but they may be inadequate at meeting the triple aim goals of improving care, enhancing patient health outcomes, and reducing per capita healthcare costs. Likewise, existing health information exchanges (HIEs) may be able to support direct messaging and transmit a continuity of care record for patients at the point of care, but may not be able to integrate or share care treatment plans, document patient interventions, support task workflows, capture non clinical social and demographic information.
In most cases, value-based healthcare delivery systems will require the adoption of new information systems and tools beyond current EMR and HIE systems.
Some healthcare providers may have purchased one, two, or even three of the four key component systems for value-based healthcare, and just need to fill the remaining gaps. Others have yet to make any of these investments and will need to purchase all four components.
Until now, acquiring these four core value-based healthcare IT capabilities often required buying software applications from multiple vendors and then integrating those applications to work together. Today, some vendors are able to offer all four value-based healthcare IT capabilities, and eTransX is one of those vendors.
Purchasing a fully integrated value-based healthcare IT solution saves time, money, implementation efforts and shortens the learning curve. In addition, data flows more efficiently and smoothly between the four applications and security management is more manageable and secure.
eTransX welcomes the opportunity to show you a fully integrated value-based healthcare information systems infrastructure. Contact us today for a presentation and demonstration.
2 Setting Value-Based Payment Goals — HHS Efforts to Improve U.S. Health Care, HHS Secretary Sylvia M. Burwell, 1/26/15 New England Journal of Medicine