Despite 2017’s cancellation of mandatory bundled payments, the value-based care movement in the United States is still healthy and will benefit in 2018 from analytics, according to a report from Washington, D.C.-based healthcare consulting firm Avalere.
In “2018 Healthcare Industry Outlook,” Avalere says new ways to collect data and advanced analytic capabilities are revitalizing efforts to turn data into insights that can inform policy and improve clinical workflows. This supports the shift to value-based care, which has continued even as the Trump administration backs away from large-scale mandatory models.
In November, the Centers for Medicare and Medicaid Services (CMS) canceled a plan for mandatory hip fracture and cardiac bundled payments that was slated to go into effect Jan. 1, sparking some concern that the action signaled a move away from value-based care. But then on Jan. 9, the CMS launched a new, voluntary bundled payment model that will be considered an alternative payment model (APM) for purposes of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) reporting.
This, along with evidence from Avalere that the private sector has not reversed course, tells us that interest in strategies to move away from the traditional fee-for-service payment model has not waned.
“Despite political transitions and revisions to Medicare bundled payment programs, the U.S. healthcare system’s transition to APMs has remained steady,” the report says. In 2017, some of the largest commercial plans were running nearly 50 percent of their medical spend through APMs and aim to go higher, according to Avalere.
Because value-based care rewards healthcare providers who prioritize better outcomes for their patients, leaders are turning to technology investments that can lower costs and improve care quality. Avalere says that data reliability and accessibility, including capturing information and creating algorithms, will drive outcomes-based contracting and a transition toward APMs.
“Success in APMs will require providers to create better infrastructure for proactive care management, data analytics, and timely integration of disparate data,” the report says. “More widespread availability of real-world data will enable new entities to leverage analytics and insight to benefit patients and their providers.”
An outcomes-driven environment requires fast and easy access to clinical and financial intelligence that can shine a light on the best possible course forward. To learn how LUMEDX data analytics can help your organization in the transition to value-based care by becoming more efficient and improving patient satisfaction, get information about the Cardiovascular Performance Program or email us at firstname.lastname@example.org.