Next Frontier in Value-Based Care: Precision Population Health
Max Anfilofyev
Chief CareBot | Scaling Patient Care 8x with AI | Chief Product Officer @ DR | Connect to scale with AI
In today's rapidly evolving healthcare landscape, value-based care (VBC) has become the holy grail for many physician practices and health plans. However, embracing the rewards of VBC requires overcoming considerable administrative burdens and navigating a myriad of complexities. For many, the struggle has been real. But it doesn't have to be.
Unraveling the Administrative Gordian Knot
The Centers for Medicare & Medicaid Services (CMS) has recognized the administrative burden of dealing with extensive lists of process-based measures. On average, physicians spend 2.6 hours per week dealing with quality measures – time they could otherwise dedicate to an additional nine patients. Moreover, staff other than physicians devote a staggering 12.5 hours per physician per week on these tasks [1].
In response, CMS has simplified the process for accountable care organizations (ACOs) by reducing the number of measures from 33 for MSSP ACOs [2] and a staggering 198 in MIPS [3], to just 4 for REACH ACOs. This reduction, which predominantly moves away from process-based measures, minimizes the proportion of revenue at risk from 5% to 2%. Such changes liberate physicians to invest their time and resources in activities that have a direct, meaningful impact on patient health outcomes.
Beyond the Low Hanging Fruit
As the healthcare community continues to evolve within value-based care (VBC), the low hanging fruits such as coding accuracy, network leakage, and referral compliance have been largely harvested. These fundamental components, though critical for initiating a practice's transition to VBC, represent only the preliminary steps towards a much broader, holistic strategy for efficient healthcare delivery.
The challenge that healthcare providers and physician practices face now is how to mitigate preventable care cost escalations. As the populations age and as practices increasingly take on patients with special needs, the complexity of healthcare management is escalating. Patients often present with multiple co-morbidities, requiring a comprehensive, holistic management strategy. A one-size-fits-all approach falls short in such circumstances as priorities change patient by patient, based on the unique needs of each individual.
Many traditional interventions, such as screening and counseling for social risks, lack strong evidence connecting them to improved health outcomes [4]. In many cases, the potential harms associated with these interventions, such as anxiety, unintended consequences, labeling, unmet expectations, opportunity costs, stigma, and legal consequences may outweigh the benefits. This dilemma puts physicians and care managers in a challenging position, struggling to balance between potential benefits and the risk of harm.
Enter: The Power of Personalization
The next frontier in value-based care is not merely to implement more complex strategies, but to embrace a fundamentally different approach - one that leverages the power of precision and personalization. A precision population health solution, like ours, addresses the critical need to manage healthcare on an individual level while still retaining a population-level perspective.
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Our solution enables physicians and care managers to identify next best actions personalized for each patient. These actions are then prioritized based on their potential to improve health outcomes and to reduce preventable care cost escalations. Instead of a uniform approach, we use large medical datasets and nuanced clinical definitions to predict personalized health trajectories. This allows us to identify and prioritize patients with preventable risks, thereby enabling providers to take proactive steps to manage patients with avoidable care costs before their conditions worsen.
This precision population health approach represents the high hanging fruit in the landscape of value-based care - an opportunity for transformative improvement in healthcare delivery. The future of value-based care is not just about doing more, but about doing it better. And our precision population health solution is the key to unlocking that potential.
Impressive Outcomes Await
Adopters of our solution have already seen impressive results. Physician practices and health plans that deployed our solution experienced a 24.9% reduction in AED event rate, leading to a 2x decrease in inpatient visits. Additionally, they noticed a $1,600 PMPM reduction per engaged member.
These results show the potential of our solution to not only ease the transition to VBC but also to enhance patient outcomes and reduce costs. By providing a personalized, data-driven approach to patient management, we can help you realize the true promise of value-based care. Are you ready to redefine your practice?
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