Guest Column | March 26, 2019

The Next Step To Value-Based Care: Activating Healthcare Data For Physicians

By Abhinav Shashank, Innovaccer

Physicians Leaders In ACO Push

Healthcare has seen a number of life-saving breakthroughs: vaccines, anesthesia, bypass surgery, the balloon catheter, and even decoding the human genome sequence. These have all changed the face of healthcare, transforming how we do things around here. But there’s one breakthrough which we have known is coming for a long time now.

That breakthrough is value-based care. Needless to say, making value-based care a reality is quite a challenge. The executives, leaders, regulators, and researchers have all pooled in their efforts to lead the transition to value-based care. But it’s the physicians who will make it happen- in their practices, in the exam rooms, in the emergency room, and at the patients’ bedside. So where are we going wrong? Why is the segment that influences a significant number of clinical decisions lagging behind in this transition?

Why Are Physicians Left Behind?

A key factor behind the slow adoption of value-based care has been the hesitancy of physicians to embrace this model.

It may sound odd to say that healthcare has been overlooking physicians, but that’s how they see it. Providers work directly in engaging with the patients and assist in delivering standardized care throughout, while still keeping a check on the sky-rocketing costs of healthcare. Since they are influencing the health outcomes on such a massive scale, they should theoretically be standing at the top of the charts of the value-based care delivery. However, missing the involvement of physicians has pushed them to navigate the value-based healthcare paradigm all by themselves and catch up as they deal with mandate after mandate.

With the government implementing new and updated payment models, it has become difficult for physicians to adapt to these plans. Even today, more than 70 percent of physicians favor fee-for-service payments. It’s very important to tie physician compensation to performance and to do it quickly. Physicians have long focused on delivering quality care, but with value-based care picking up the pace, they need to focus on equally important goals as well, such as reducing utilization and the cost of overall care.

On top of that, physicians are continuously working long hours. The Annals of Internal Medicine found that for a physician, 49.2 percent of their time goes into doing paperwork, including EHRs, compared to 27 percent of their time seeing patients. A lack of meaningful incentives combined with increasing rates of burnout is just keeping physicians away from adapting to value-based care.

We need to remember that any change regarding value-based care needs to be embraced by the physicians. We’re talking about fixing healthcare, and it’s going to require radical transformation. Moving from a system organized around individual physicians to one that enforces a team-based approach needs physicians to be a central player. So, without physicians onboard for this journey, it is nearly impossible for healthcare organizations to have a win-win situation.

Out With Disconnected Physicians. In With Activated-Data Driven Physician Engagement

Compared to the easy fee-for-service model, physicians have cited complexities associated with this value-oriented model. One of the primary ideas to ensure success is engaging providers efficiently.

The biggest disconnect exists between the network and the physician. Provider organizations are going leaps and bounds to integrate their clinical and claims data together, analyze their performance, and pick the right quality measures that best reflect their performance- which is a very significant first step.

Additionally, as healthcare is traversing into a data-driven ecosystem, physicians need to ensure proactiveness in delivering care to their population. Giving physicians access to relevant and timely data is more effective than them drilling down multiple healthcare records to find out what their patients’ story is. Also, when physicians have access to a detailed summary of screenings outstanding for each patient, they can directly qualify the target quality measures.

Apart from this, organizations should involve physicians in formulating new policies. Leaders should understand the gravity of the provider’s opinion, as they are the ones who directly connect with the patients and are the first-hand recipients of their issues. Giving them the center place can directly improve not just their working state, but also can affect the population health to an extent.

The Road Ahead

Be it the adoption of value-based care or delivering care- physicians require transparency. Physicians want to solve healthcare problems, and they need to be engaged all the way. They must be able to surface their concerns and be treated as equal partners in achieving value-based care. It’s time healthcare segments ended the differential space and understood the need for integrating as one entity without compromising the sole aim of value-oriented care.