Deriving Insights With Value-Based Care Metrics

Digital and Data Services Overview

Traditional contract management applications and systems were not built to be able to deal with the nuances of value-based contracts and can serve as nothing more than an elementary and incomplete repository of static administrative elements of such contracts.

As value-based contracting (VBC) adoption increases across the industry, the need for a comprehensive management tool will be essential to capture, track and monitor all the critical elements within these complex agreements.  With the increased granularity and specificity surrounding these value-based contracts, a tailored, interactive application built from the ground up with various landing pages and multiple data interfaces will be needed to capture the nuances and more importantly document key measurement statistics and calculate upside / downside risk and trend performance on key quality metrics over time for optimal contract performance management. 

Industry and Functional Applicability

Healthcare organizations could have hundreds of unique VBC arrangements across the spectrum, from P4P to Full Risk, with specific measurements, different quality metrics and multiple reporting requirements in a single contract.   Many organizations struggle to keep up with this disparity between agreements and are unable to fully understand what they have committed to and how to appropriately measure the success of these contracts. 

ROI Optimization

One way to enable more transparency of these complex details is though the creation of a comprehensive business intelligence dashboard used as single source of truth that can be accessed by all key stakeholders (VBC steering committee, actuarial team, payor relations and contracting, data analytics, population health and clinical operations) throughout the organization. 

Some key benefits of this type of management tool include;

  • A comprehensive evaluation of current capabilities and development of value-based contracting structures across the organization
  • The ability to evaluate quality and financial performance for multiple contracts across the organization
  • The capability of evaluating performance on an individual basis as well as comparing contract to contract through the establishment of a consistent set of measures and methodology
  • Better identification and understanding of the key drivers of quality performance
  • Improved ability to establish appropriate performance targets to access shared savings

By digitizing key VBC elements across agreements into a user-friendly interface, an organization will be able to easily identify similarities and differences among contracts, areas for performance improvement (financial and quality) and reporting on actual vs. expected revenue performance.

Additionally, the dashboard should be set up to incorporate claims data and other critical data elements to manage contract performance against established targets. By doing so, healthcare organizations can fully maximize the true monetary and quality outcomes from these agreements.

The DownloAAd is a Blog Series featuring the latest tips, trends and thoughts from the experts leading AArete’s Digital & Data Services practice. To learn more about AArete’s Digital & Data Services capabilities, click here. To learn more about the minds behind the blog, read more and connect with the author below.