Healthcare is approaching a tipping point in its evolution to a tech-enabled, data-driven industry. As providers implement value-based care initiatives to reduce costs while improving care delivery and population health, data analytics has become an invaluable asset for identifying care gaps and areas for performance improvement. Increased insight into operational and individual practice performance data is changing traditional clinical and business models to promote better outcomes.
Accountable care organizations (ACOs) helped pioneer the role of shared savings models in driving quality improvement and cost-e ectiveness. As more clinically integrated networks (CINs) and other healthcare entities make the leap to similar payment models and risk-sharing contracts, providers are embracing the use of data analytics to inform decision-making and smarter resource use across the healthcare ecosystem.
Despite heavy investments in health IT, many organizations struggle to navigate the transition from patient data aggregation to analytics-driven action. This article highlights steps that CINs, physician practices and other interconnected stakeholders can take to implement a data analytics infrastructure that supports ACO and other value-based care initiatives.
A key tenet of the CMS Quality Strategy is to put the power of healthcare information to work to change the way care is delivered through increased attention to population health and care coordination across settings. As provider organizations attempt to build collaborative care networks and implement population health management (PHM) strategies, establishing sustainable governance and infrastructure to align the care team around common goals is a vital rst step.
Under shared savings models, providers earn a percentage through the group’s collective e orts to reduce spending. Incentive distribution methodologies typically tether cost and utilization metrics to provider performance measures. Establishing an aggregate view of network-wide performance data represents an analytics imperative for ACOs and CINs.
For these providers to fully understand costs, patient risk and partner performance, a centralized view of clinical, nancial and operational data across physicians’ disparate systems and di erent locations must be established.