Providers and payers both win when they share population health data (Healthcare Finance)
Healthcare Finance looks at the “one two punch” of both providers and insurers using data analytics to conquer “the sometimes elusive savings in value-based care.”
The article uses Anthem as an example, discussing how the insurer’s predictive analytics “give providers an opportunity to do interventions, gives them knowledge on outside care visits, such as to a behavioral health specialist, on those at highest risk for being admitted or readmitted, and on gaps in care.” This is of particular relevance to those providers in a share-risk contract with Anthem although “for providers not in risk contracts, the data gives a push to lower cost and increase quality.”
Another example given is Benevera Health in New England, a joint venture that combines providers, payers and analytics. “Benevera combines the electronic medical record data and claims data to create a population health entity and patient stratification...[and] the results show a reduction in cost in the 30 to 40 percent range for the patients engaged through population health efforts.”
DCHI is working in the same direction with its Payment Model Monitoring Committee, which advocates for the transition of all payers, providers and health systems to a value-based payment model by 2020. This approach , which includes the use of health information technology, supports DCHI’s broader delivery system transformation (including population health improvements). For more information on how DCHI is moving hospitals and provider groups towards a value-based payment model, with a goal to have 80 percent of Delaware’s population in value-based payments by 2019, please visit us at https://www.dehealthinnovation.org/.
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