A surprising way to improve the success of value-based care programs: Quantifying and leveraging relationships with patients

As providers offer value-based programs, the strength of their relationships with patients can be a significant factor in the programs' success. 

During a July webinar hosted by Becker's Hospital Review and sponsored by Nascate — a company focused on making value-based care more effective and efficient — James Lawson, Nascate's Executive Vice President of business development and marketing, discussed the importance of patient-provider relationships in value-based programs.

Four insights from the webinar:

1.) Success in value-based care programs requires a whole-person view. Healthcare suffers from the "streetlight effect." This term comes from the story of a man looking for lost keys under a streetlight. While the man lost his keys in a park, he looked under the streetlight "because that's where the light is." This is observational bias, Mr. Lawson said: "We often look for things where it's easy ... not where it's necessarily effective."  

While it's critical to measure and manage clinical measures, these measures don't always correlate to an improvement of the overall value-based care objective. According to Lawson and the team at Nascate, providers need to "refocus the lens from a metrics-based perspective to a person-centric view." 

2.) In the current state of value-based care, there are significant challenges and opportunities. Value-based programs still often represent a small portion of many providers' patient populations. Providers are hesitant to take on more value-based risk, which minimizes the scale and impact of these programs. One reason for hesitancy is that it is difficult to quantify the strength of the patient-provider relationship and know which programs work and provide value for which patients. Other challenges include lack of physician buy-in and lack of financial incentives to change providers' behavior.

Opportunities to improve value-based programs include having a greater emphasis on the whole patient, using longitudinal data, quantifying the quality, cost and impact of the patient-provider relationship and viewing people as healthcare consumers, not patients. 

3.) Use cases exist for applying relationships in value-based programs. Two use cases for leveraging relationships in value-based programs are:

A.) Enhancing current attribution models. Attribution is a foundational, if not the foundational methodology when it comes to managing or deploying value-based programs. Now, organizations can use relationships as the basis for attribution, allowing more flexibility, transparency and stability. Relationships can supplement existing attribution results. 

B.) Creating a personal profile. A whole-person profile includes various social and behavioral data. "Once you bring everything together, it is an infinitely more comprehensive story than if you're simply looking at just the clinical view of a person," Mr. Lawson said. This profile can also include data on the strength of the patient-provider relationship — stratified as strong, medium and weak. The hypothesis is that providers are in a better position to manage care for people with strong or medium relationships. 

4.) Strong relationships can decrease costs, making relationships a key to success in value-based care. Nascate has quantified the value of strong physician-patient relationships. Analysis shows that a person with a strong relationship with their physician will experience approximately $1,000 less in annual healthcare expenditures compared to a person with a weak physician relationship. Patients with strong physician relationships also have lower inpatient costs (30 percent lower) and 30-day readmissions (24 percent less).

Mr. Lawson pointed out that organizations can develop analytics that leverage relationships using standardized data. These analytics can be used to segment patients, target value-based programs, improve care engagement and drive value-based success. 

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