Under traditional volume-based care, health systems are accustomed to looking at patient outcomes, total cost of care and financial results as separate issues. But with value-based care these issues are inextricably intertwined.
The stakes could not be higher. Nearly all value-based payment systems are zero-sum games. This means health systems that perform well on patient outcomes are rewarded financially at the expense of those that lag behind. This dynamic is repeated annually so improving health systems continually gain advantage. It’s as if The Hunger Games has come to healthcare.
In fact, many systems will not survive. The organizations most at risk are those treating value-based care initiative as a “bolt-on” program rather than completely re-wiring clinical and financial practices.
Emerging technologies are helping health systems manage this complicated transition. Value-Based Performance Management Analytics, recognized by Gartner as a new category distinct from traditional analytic technologies, is designed to fill this pressing need. While traditional healthcare analytics generate reports, value-based performance management takes the next step to answer the critical question: “What do we do with the data to improve performance?”
Here are four primary ways performance management helps health systems navigate from volume to value:
1. Tackle Change Management Issues
Change management in healthcare is challenging because of organizational complexity, operational silos and irrational variation in care, just to name a few. Telling people to “work differently” isn’t enough – especially when working with highly independent physician stakeholders.
Traditional methods focus on the numbers—getting data, running calculations and producing reports with the right numbers. These change management methods are completed manually, error prone, slow and painful. But no amount of crunching numbers compares to the challenge of change management, physician engagement and alignment. Value-based performance tools, such as those offered by WhiteCloud Analytics, help smooth and accelerate this process in ways that will be welcomed by anyone interested in reducing the number of meetings, reports and slideshows.
2. Tame Complexity and Data Overload
Healthcare is complex. But value-based care takes this complexity to a new level with dozens of contracts with individualized performance metrics; numerous specialties that measure patient outcomes differently; and thousands of physicians, care providers, and support staff who need clarity on new expectations.
Performance management tames this complexity by bringing all planning and metrics into one platform that supports both integration (for the big picture) and high-fidelity disaggregation (so every decision maker and care provider knows what performance means for them). Quality, safety, service, efficiency, margins, claims, total cost and more are integrated, regardless of the data source. By reducing complexity, value-based performance management supports high-performance execution.
3. Engage Physicians as Change Agents
Physician engagement and alignment are essential for this transformation, particularly because care models must be reengineered and deeply linked in the business model. Value-based performance management empowers physicians as world-class problem solvers to drive the transition by aligning incentives, identifying unnecessary variation and providing visibility into overall effectiveness. As a result, physicians can help set clear goals with concrete expectations, align teams and incentives, and communicate the downside of inaction. This approach will mobilize organizations – not all at once, but in a collective, growing momentum.
4. Automate for Continuous Improvement
Traditionally, healthcare has handled complexity with a manual, human staffing approach. But with the intricacy and time demands of value-based care, this is an overwhelming and ineffective method. Value-based performance management automates change management by moving it to a digital platform so the whole process moves faster and can be scaled. Automating autonomous care provider performance management frees analysts and data teams to work on important strategic projects that cannot be automated.
Value-based performance management tools provide the foundation for an ongoing improvement process through planning, stakeholder alignment, proactive improvement, rewards and recognition. As this continual looping process unfolds, the need for a system-wide automated and integrated performance management system becomes clear.
From Strategy to Execution – the Critical Link
Countless research studies and CEO surveys have pointed out that the number one cause of organizational failure in times of change is not faulty strategy, but failure to execute strategy effectively. Time is a critical factor – those health systems that execute their strategy quickly are going to improve faster, and they will be on the upper end of the new payment models. The further performance lags behind, the harder it will be for a system to catch up. By executing these four strategies with speed and accuracy, health systems can survive and thrive in value-based care.
Bob Lokken is co-founder and CEO of WhiteCloud Analytics, a leading provider of value-based performance management solutions
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker’s Hospital Review/Becker’s Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.
