By Lisa Hebert, director of product management, NantHealth.
Our industry is stuck in an inefficient, costly trend—treating avoidable diseases rather than preventing them. According to the Centers for Disease Control and Prevention (CDC), chronic diseases, such as diabetes and heart disease, account for 75 percent of our nation’s healthcare spend. Shifting our focus to wellness will improve patient health and reduce overall healthcare costs.
How do we get there? A transition to preventative care requires value-based care that is aimed at the long-term needs of individual patients. Patient-centric and evidence-based, the model leverages vast amounts of historical healthcare data and advanced analytics to provide clearly defined routes to well-established, evidence-based treatments with proven effectiveness. It helps providers assess risks, benefits, and trade-offs of specific treatments, avoid unnecessary treatments and costs, and deliver more accurate, better quality care that keeps patients healthy throughout their lives.
Value-based care benefits all participants—healthcare providers, facilities, and plans, and the patients they serve. It’s dependent on active, ongoing participation from all parties. Collaboration is critical to its success.
Leveraging Technology to Collaborate
A value-based care system requires robust technology to replace manual tasks, reduce inefficiencies, and support the transfer of patient data in a secure, timely and comprehensive way. Done right—interoperable and seamlessly integrated with existing workflows—automation technology can enable patients, providers and payers to communicate and collaborate in meaningful ways, while saving significant costs. It is estimated that the industry could save $12.4 billion by fully adopting electronic transactions that enable them to exchange vital information in near real-time and more readily communicate and collaborate to deliver care with delay.
Collaboration is a Win for Providers, Plans and Patients
Automating the transfer of health plan and patient clinical data and care information enables better collaboration between all stakeholders in the healthcare ecosystem, empowering them in their value-based care roles:
- Plans become participants
Healthcare plans transform from traditional gatekeepers to active participants in delivering quality care. A better view of historical data and proven pathways helps them make more accurate recommendations and take proactive measures to reduce hospitalizations.
- Providers can shift their focus to prevention
Seamless, near real-time access to clinical information like patient summaries, high-risk patient lists, and care gaps enables providers to proactively manage their patients’ care. Like plans, they can utilize data from a wide population of similar patients and more accurately prescribe treatment plans, identifying proactive steps to avoid specific illnesses, manage chronic conditions, and help to improve their patients’ overall wellness throughout their lives.
- Hospitals and healthcare facilities become more efficient
The right technology readily adapts to provider workflows and applications by incorporating documents within the context of existing workflows, such as Eligibility and Benefits verification. It eliminates the need for time-intensive, error-prone paper shuffling and manually intensive processes. By improving efficiencies, quality of care increases, unnecessary tests and procedures are eliminated, hospital admissions—that now average about $10,000 per visit—decrease, and hospitals and care facilities become less crowded and better able to address patient needs.
- Patients are healthier
Patient-centric care prioritizes the needs of individual patients over the long-term and improves the quality of care they receive. They are able to avoid unnecessary treatments and steer clear of potentially chronic conditions, enabling them to live healthier, more enriching lives.
With a commitment to collaboration—and the right technology to facilitate it—value-based healthcare promises to improve the health of patients and reduce the costs incurred for their proper care.