Using Real-Time Insights to Improve Value-Based Care Outcomes

Given the healthcare industry’s move towards value-based care (VBC), enhancing the quality of patient care and reducing the overall cost of care are becoming increasingly important priorities. Not only is this a focus for many providers and healthcare organizations, but the government has also taken steps towards furthering VBC. For example, the Centers for Medicare & Medicaid Services (CMS) has said that all Medicare beneficiaries must be covered by VBC models by 2030.

But even still, the transition to value-based care is in its early stages, and there is evidence to suggest that many healthcare organizations are struggling with the challenges of this model. According to a 2021 survey by the National Association of ACOs, many accountable care organizations (ACOs) were struggling with financial sustainability, with 81% of ACOs reporting that they were at financial risk. The survey also found that ACOs were facing challenges with data sharing, patient engagement and care coordination.

One of the main issues is the lack of real-time patient data, insights and analytics to inform clinical decision-making. Without this critical information, healthcare providers are unable to make the best decisions for their patients during the moments that matter, and ensure they receive the highest quality care. Adding to this issue, providers today oftentimes struggle to appropriately find and implement the use of real-time data in their practices for a variety of reasons.

First, patient data is typically fragmented and disjointed within healthcare, which overwhelms providers. Even if providers have access to patient data, it’s frequently raw data that requires sifting through and analyzing to inform their clinical decisions. Further, these data may not be available at the point of care, meaning providers are left to search and decipher this information when they aren’t seeing patients or tending to other clinical matters. In most healthcare practices, providers simply don’t have time to do this for each of their patients. These challenges then result in both administrative and clinical burdens for providers and their care teams. 

To solve this, providers need access not only to patient data, but accurate, timely and distilled insights to make the best decisions for their patients and ensure they receive the highest quality care when they need it most. Fortunately, the implementation of healthcare technology can help providers distill raw data into actionable intelligence. Moreover, integrating real-time patient insights into clinical workflows can also help address some of the challenges in VBC, such as reducing costs, improving quality of care and enhancing patient satisfaction. This means providers can focus on patient care while ensuring they have the information, they need to improve health outcomes when they need it most.

Implementing this technology not only improves patient outcomes, but it also enables fluid insights to be shared amongst providers and payers. This is particularly imperative during high-impact moments in a patient’s care journey, like post-treatment follow-ups, screenings and during transitions of care, such as when a patient is discharged from the emergency department. In these situations, every second counts, and having the right information at the right time can make an immense difference. This also allows for enhanced care coordination between all parties and results in timely interventions that ensure patients do not fall through the cracks. Further, the enhanced care collaboration efforts help support quality measures that have been directly built into VBC models, such as CMS Star Ratings and HEDIS measures.

By integrating technology into clinical workflows and increasing collaboration between providers and payers, the healthcare industry can also identify gaps in care via real-time notifications and ensure they’re closed in a timely manner. This means providers and health plans can identify patients who are developing complications or haven’t had their health need addressed, monitor their progress and intervene to prevent or address adverse events. This approach can not only improve patient outcomes but also reduce the need for costly interventions and hospital readmissions.

As our industry continues to shift towards and prioritize value over volume, real-time patient insights empowered by technology are critical to the success of VBC models. By addressing these challenges and leveraging the proper technology to help solve them, we can improve patient outcomes, lower the cost of care and further the successful adoption of value-based care.