Healthcare Leaders Disrupt Payment Models With Data Analytics

Healthcare Leaders Disrupt Payment Models With Data Analytics

How data can forge new pathways in value-based care

Both data analytics and value-based payment models are hot topics in healthcare, as payers and providers strive to lower costs and increase efficiency. When these two powerhouse market segments combine, though, it is possible to leverage even greater results. Read on to learn about how data initiatives can disrupt and enhance value-based payment models.

The recent SAS Health Analytics Virtual Forum featured an executive panel discussion that emphasized the importance of data partnerships in the healthcare industry, particularly with regard to new payment models such as value-based care and bundled payments, as reported by Fierce Healthcare. Leaders from the Cleveland Clinic and Humana explained that the transformation of payment models in healthcare relies heavily on data analytics. Targeted, personalized care depends on the ability to analyze, interpret and apply patient data. Data-driven partnerships, in which payers and providers share financial risk, reduce the “adversarial” nature of traditional payment models and pave the way for personalized interventions and innovations in care delivery.

Similarly, healthcare executives at the recent Becker’s Hospital Review 8th Annual Meeting held a roundtable discussion focusing on the use of data analytics to streamline revenue cycle processes and improve patient experiences. As Becker’s reports via Change Healthcare, the transition to value-based care transforms patient treatment, moving beyond just clinical care to focus on various elements of patient satisfaction. As a result, patients expect a more retail-like experience, and hospitals must adapt to this model or risk financial losses. Data analytics can provide insight into patient behavior and preferences, as well as predict a patient’s propensity to pay. Attention to both patient satisfaction and revenue cycle management allows for more personalized care and potential avoidance of financial problems or losses.

The November 2016 Value-Based Care Summit also focused on the promise of data analytics. Speaker Steven Strongwater, M.D., of Atrius Health shared insights with Strongwater explained that big data analytics tools help healthcare organizations to meet value-based care goals in several ways. Data analytics can: assess cost and quality performance; monitor and improve organizational progress toward stated goals; identify clinical inefficiencies and at-risk populations to improve care coordination and patient engagement; pinpoint opportunities for patient intervention; and improve the patient experience. Strongwater also cautions against potential administrative burden and provider burnout caused by value-based models, however.

Healthcare leaders are clearly concerned with the transition to value-based care, and are seeking ways to harness the power of big data analytics to improve patient care and reduce financial losses. Healthcare IT professionals must remain aware of these issues and attuned to changes and trends in both payment models and data analytics, particularly as these two fields increasingly overlap.  

Additional Reading:

  • Health IT Analytics, “Smart Big Data is Key to Population Health, Value-Based Care”
  • Health Payer Intelligence, “Clinical Data Analytics Key for Value-Based Care Reimbursement”
  • Healthcare Informatics, “Tailoring Healthcare Analytics to a Value-Based Future”
  • IBM, “Predictive Analytics in Value-Based Healthcare: Forecasting Risk, Utilization, and Outcomes” (downloadable white paper)
  • Search Health IT, “Data analytics aids value-based reimbursement, but bigger goals loom”