The value philosophy is evolving, along with the abilities required to promote the transition to value-based care. Payers and providers, from the Triple Aim to the cost versus efficiency measure to the proper place-right time-right care model, have struggled to identify a unified sense of value. Because of this, several discussions over value-based treatment between the two parties have yet to yield results.
The pandemic has provided a silver lining in the sense of a boosted interest among payers, providers, and other healthcare stakeholders to cooperate and achieve a common target to ensure the availability of highly valued services.
During the early stages of value-based care, leading industry bodies were centered on achieving patient and financial data. But as value-based clinical approaches also developed, measurements that integrate metrics on social determinants of health and other factors that apply holistically to patient care have also seen growth.
Providers need data analytics resources to recognize the relevance of the programs they deliver and create a roadmap for providing value-based treatment to each patient. However, by sharing their surplus of medical information with physicians, payers can also aim to change to maximize value.
Using Humana as an example, it has focused on addressing food scarcity, a crucial social determinant of well-being, since the pandemic. The payer also described members who are food-deprived and not necessarily in the traditional sense. Some were reluctant to step outside their homes due to transmitting coronavirus concerns, so outreach teams were formed to address the underlying causes of food insecurity and identify individual needs.
With more integrated data that focuses on the patient, the healthcare system will be able to move to a more optimal definition of value.
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