Many healthcare providers and payor organizations use analytic solutions that streamline communication, manage population health data, and identify necessary gap closures to navigate the transition to value-based care. AWS Marketplace wanted to understand just how technology is helping healthcare organizations’ value-based care efforts. This article shares the results of a research study commissioned by AWS Marketplace and provides insights into the continued growth of value-based care.
Read this article to:
- Understand the overall industry challenges of value-based care for healthcare provider and payor organizations
- Learn about the analytic technologies needed to enable further success
- Discover how AWS Marketplace can help accelerate innovation
Challenges of value-based care
Communication with providers
Before the implementation of the Affordable Care Act over a decade ago, value-based care was more of a concept than a tangible method of delivering high-quality, affordable care. When the law passed in 2010, it incentivized healthcare organizations to focus more meaningfully on these alternative payment models that push the industry away from volume-based care.
Eleven years later, the industry has made significant progress toward more value-based care. The most recent data from the Health Care Payment Learning & Action Network, for example, shows that less than half (39.1 percent) of healthcare payments made in 2018 were from fee-for-service models.
On the other hand, the healthcare industry still has a long way to go before operating in a completely value-based environment. That same data reveals that just 36 percent of payments made by private and public payors were tied to an alternative payment model, while the remaining payments were through less advanced value-based payment models that rely on incentive payments or upside-only rewards.
The biggest challenge to value-based care adoption is communication. Contracts between payors and providers for advanced payment models first begin with conversations to align goals and values. Once contracts are implemented, gap closure information needs to be communicated with providers in order to yield value-based care success. Providers need to be informed about gaps that should be closed and how to best hit quality targets.
Technologies for population health management and predictive analytics can also help with these aspects of value-based care, but only if this information is communicated effectively with key stakeholders.
To understand what technologies healthcare organizations are using and how these key metrics are communicated with providers to inform value-based care efforts, AWS Marketplace commissioned a survey of industry stakeholders.
The survey yielded 108 responses from payor and provider organizations that provide insights into the continued growth of value-based care and the technologies needed to enable further success. Results highlight the challenges of successful value-based contracting and call for a wide range of technologies interoperable with existing systems to meet the business needs essential to value-based care growth.
Challenges of value-based care
Consistent with industry trends, many (64 percent) survey respondents are participating in value-based care. This proportion is smaller than some might anticipate, but value-based care efforts have stalled during the COVID-19 pandemic when priorities shifted to tackle the immediate challenges created by the pandemic.
Those organizations that were involved in value-based care reimbursement, however, were relieved they were. The COVID-19 pandemic highlighted the shortcomings of the fee-for-service system—primarily, providers do not get paid in the event entire offices or service lines are shut down to stop the spread of disease. Additionally, value-based reimbursement models offer the flexibility to implement telehealth and other remote care options.
The pandemic brought to light the need to expand the adoption of value-based care models. But the challenges to value-based care reimbursement that existed prior to the pandemic did not disappear. The biggest challenge respondents report is not knowing where to begin. Nearly half (49%) of respondents cite this as a fundamental challenge to value-based care participation. Another 43 percent say they lack partners for value-based care.
The COVID-19 pandemic is not the biggest reason organizations are not participating in value-based care. It is a lacking of partners and knowing where to begin in the process towards value-based care that stalls organizations. To be successful, it is critical to promote partnerships with organizations that understand the challenges of value-based care. Communication with essential partners can give organizations a starting point to shift to offering value-based care and develop strong relationships with other organizations that enable success.
Once partnerships for value-based care begin, communication must continue to promote further innovation and development of the models. Organizations that are participating in value-based care efforts say the biggest challenge to success is provider uptake or behavior change, which was cited by 65 percent of respondents.
A reason for this hesitation among providers can be a lack of transparency. Providers do not know the expectations set for them or feel ill-equipped to meet the new, more sophisticated demands. Many organizations leverage population health data insights to increase provider awareness of necessary gap closure measures and quality targets.
But more than half (53%) of survey respondents say having these insights is a challenge for value-based care implementation. While the technologies exist to provide clinicians with these insights, survey results demonstrate how these technologies are not leveraged as often as they should be.
Population health data can highlight necessary gap closures and direct resources to high-risk patients. The technology could enable data transparency and promote more successful value-based care initiatives.
The analytic technologies healthcare organizations are currently leveraging for value-based care include provider dashboards and cloud-based storage, according to 63 percent of survey respondents.
For the 49 percent of respondents who do not know where to begin with value-based care efforts, trying to understand which dashboard solution to choose from a slew of options can be overwhelming. Finding the right solution to fit the unique needs of a healthcare organization is a challenge, yet stakeholders know they need these insights for successful value-based care. Tools that make it easy to filter and sort products can help organizations find the technologies that best fit their needs.
What works well for one organization does not necessarily work for another. However, every organization needs the ability to communicate data with payors and providers alike if they want to make meaningful strides in value-based care.
“The University of Michigan Health Infrastructures and Learning Systems (HILS) program needed a platform that allowed students to test, query and combine information from multiple target sources,” Helen Hill, board director of public policy at Michigan Chapter of HIMSS told AWS Marketplace. The organization tapped AWS, which according to Hill, “offered students an effective way to test their work and advance curriculum development towards closing critical healthcare delivery gaps.”
Another key element analytic solutions need is interoperability with existing clinical and business systems. Sixty-nine percent of respondents point to this as a key feature when selecting a new vendor technology. Stakeholders want to invest in new tools that work well with systems already in place. Having the connection between new and existing platforms promotes ease of use and adoption.
“InterSystems [available in AWS Marketplace] will help us connect the dots on every patient record, delivering information to California payors and providers as they move toward value-based care,” emphasized David Kates, chief technology officer of Manifest MedEx.
Integrating solutions into existing workflows and systems enables speedy delivery of information to stakeholders, so industry leaders are prioritizing interoperability when selecting an analytic solution.
But the need for interoperability and data transparency is not necessarily being met by a single vendor. Only 15 percent of respondents are working with one vendor for all their analytic needs. Most organizations are using multiple vendors because healthcare is not a one-size-fits-all model. There is a need to review and assess multiple vendors and compare them to fit an organization’s needs.
Communication with providers
Data transparency and interoperability of analytic technologies are essential for value-based care because success hinges on effective communication. Data gathered from analytic solutions must be communicated with providers so they are armed with data to inform how they practice. Data transparency points to gaps in care a provider needs to close and allows the provider to look at the patient population as a whole.
Most organizations are communicating these key quality, gap closure, and patient experience metrics with providers on a monthly (30%) or quarterly (29%) basis.
Frequent communication of these measures helps providers alter care delivery to enable success in hitting key quality measures intended for value-based care success.
But 19 percent of organizations are still giving providers hard copies of this information. In a digital world, this strategy feels antiquated and sub-optimal. Existing solutions can streamline these processes, eliminating the need for paper-based communication and increasing the frequency of communication. Providers should not have to wait a month or several months to become aware of pressing issues or opportunities to close gaps when the information is available in near real-time.
Some (28%) organizations are using internet-based dashboards or portals to communicate these strategies with providers, and 15 percent are using desktop-based dashboards or portals. While this is a trend in the right direction, it highlights a gap in the industry. Less than half of healthcare organizations report using technology solutions to inform providers of evolving data insights.
These solutions exist and should be more broadly promoted and accessible so provider knowledge and awareness can grow to align with organizational efforts toward value-based care.
The industry-wide growth in value-based care has simultaneously increased the need for solutions that enable contract success. Data analytic platforms and communications tools are just a few on a list of solutions that can better deliver critical information to stakeholders, align practice with organizational goals, and streamline workflows by integrating with existing systems.
Where many organizations struggle, though, is understanding where to begin. AWS Marketplace gives healthcare organizations access to cost-effective and flexible software solutions that enable fast innovation. The digital catalog of third-party software, services, and data makes it easy for providers, payors, and healthcare IT companies to find, buy, deploy, and manage software for successful analytic strategies that promote value-based care.
With thousands of third-party software, professional services, and data listings across over 50 categories, industry leaders can find the tools that best suit their organization’s unique needs. And solutions are interoperable with existing cloud systems, simplifying the cloud journey. As each organization has a unique set of guidelines and compliance needs, AWS Marketplace has the ability to build a private marketplace for an organization’s pre-approved software.
Organizations no longer have to worry about the uncertainty of where to begin. Starting with AWS Marketplace will allow healthcare organizations to find the solutions they need to succeed in analytics, interoperability, and value-based care at large.