Healthcare Analytics, Population Health Management, Healthcare Big Data

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74% of Execs Say Interoperability is Critical for Value-Based Care

As momentum continues to build around value-based care models, healthcare leaders see interoperability as a critical competency for success.

Interoperability is critical for value-based care

Source: Thinkstock

By Jessica Kent

- Over 70 percent of healthcare financial executives say that data interoperability must improve within the next three years to ensure the success of value-based care, according to a Healthcare Financial Management Association (HFMA) survey sponsored by Humana.

Organizations are aiming to improve both their external and internal interoperability to allow greater visibility into financial and clinical opportunities, the poll found.

“Interoperability has the challenge of collecting fragmented health data and exchanging the information across multiple systems. In addition, it must provide physicians access to comprehensible patient health information at the right time for informed decision making and better efficiencies,” says Roy Beveridge, MD, Humana’s Chief Medical Officer.

Currently, many organizations are lacking these skills.  Thirty-five percent of respondents said they don’t have the tools or technology needed to assist in specialty or inpatient care to help control costs, and 55 percent anticipated a need for improved chronic care management in the next three years.

“Overcoming the interoperability barrier becomes even more important for treating patients with chronic conditions as they generally see multiple physicians and specialists,” Beveridge says.

Effective chronic disease management also requires access to patients’ social determinants of health, which have a profound impact on health outcomes. 

Executive priorities for value-based care

Source: HFMA

The majority of organizations that have access to social determinants of health report that they don’t leverage this data. Only thirty-seven percent said their organizations consider social determinants in their overall strategy and cost planning. This number may increase as more organizations adopt value-based care models and seek to better understand the non-clinical factors that affect patients’ health.

The survey suggests that data sharing and interoperability issues may have slowed value-based care implementation. In 2015, adoption was projected to increase to 50 percent in 2018, but the survey shows that adoption has only grown from 12 to 24 percent since 2015.

However, the survey also shows that the return on investment for value-based care models has improved in the last two years.

Seventy-four percent of organizations that have made the switch to value-based care payment programs have achieved positive financial results.  In contrast, just 51 percent of organizations said the same in 2015.

To help accelerate the adoption of value-based care models, researchers suggest that health plans and payers increase data sharing, act as partners with providers, and standardize their programs and processes.

“Collaboration among health systems, physicians, and health plans is the key to growing value-based payment,” says HFMA President and CEO Joseph J. Fifer, FHFMA, CPA. “Technology and other obstacles can be overcome if all stakeholders commit to working together for the benefit of the people we serve.”


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