Value-Based Care Blog 1

Value-Based Care Transformation: How some providers are measuring success

It has been nearly nine years since the Institute for Healthcare Improvement launched initiatives designed to simultaneously improve the patient experience, improve the health of populations, and reduce the per-capita cost of healthcare. Now, unaligned incentives along with fragmentation and lack of coordinated care continue to be major issues within the U.S. healthcare system. Payment reform is attempting to address unaligned incentives through new reimbursement models that link payments based on performance with the quality of care for individuals and populations across settings. New care-delivery models have attempted to address coordination and collaboration of care for individuals and populations across multiple care settings.

Although one goal of these new care-delivery models is to secure value-based contracts, other goals may include understanding and managing population health, improving the patient experience, and reducing costs. Regardless of the reason for beginning the journey to value-based care (VBC), almost all providers we speak to agree that they can’t successfully make the journey alone. In fact, many providers have made large investments as they have enlisted firms to provide consulting or ongoing services to help them make the transition to VBC, and the impact of these engagements can be measured in provider progress toward four measurable goals:

  1. Improved patient access and satisfaction
  2. Improved clinical care and outcomes
  3. Reduced healthcare delivery costs
  4. Improved ability to enter into future risk-bearing agreements

In an effort to measure the impact of the consulting firms and vendors providing ongoing services, KLAS asked providers to rate firms in the above four areas, and the results provided some interesting insights into the firms positioning themselves to be partners in your transition to VBC.

More than 150 healthcare executives shared their stories with us and revealed in clear terms how challenging it is to improve clinical outcomes and patient satisfaction while keeping a lid on total spending. With that being said, we also spoke to many who have taken on and overcome that challenge over the past decade. We spoke to many more who are just at the beginning of the largest industry transformation in the past century.

The truth is that for the majority of providers, it is too early to tell what impact the engagements might have in the four key areas; most have just started to engage firms in their VBC journey. Additionally, some providers did not engage firms with the expectation that the firms would deliver outcomes in an individual category. After filtering out these N/A results, KLAS identified which firms are making the strongest impact in each of the four measurable areas.

Next month, we’ll take a deeper look at the firms your peers thought were most effective at helping them confidently assume more risk.