Successful value-based contracting requires a similar approach, in that payers and providers must share vast amounts of data during the negotiation process to properly evaluate different VBR options. To address the unease associated with this level of sharing, payers and providers need a neutral third-party partner who can assist them with the design, measurement and collaboration of VBR contracts. Blockchain holds potential to address this problem in the future but is still a long way off from widespread adoption.
Measure quality by standardizing information: Collections of standardized information on groups of patients who share key characteristics – patient registries – help providers obtain a greater level of granularity in examining and evaluating different procedures, episodes and conditions. Healthcare organizations aggregate this information to mine the data for insights into what works best, pointing the way toward opportunities to boost quality or lower costs.
Similarly, one of the most fundamental concepts of VBR is to incentivize changes in behavior to adopt best practices discovered by aggregating and analyzing patient data. One way of measuring success in VBR is through provider adoption of best practices, such as appropriate medication usage for patients with a certain condition.
This data aggregation, analysis, and quality assessment is also used to monitor and fine-tune the VBR contractual agreement, enabling participating payers and providers to continuously shape their networks and standards of care to optimize patient outcomes.
Overcome trust barriers to work together: To help providers navigate the adoption process of electronic health records, the federal government about a decade ago created regional extension centers. Their purpose was to assist primary care providers in a shared geographic area, helping these often competing medical practices to move toward the goal of higher-quality care through better technologies and processes.
Scalable VBR agreements between payers and providers are similar in that they depend on these traditional rivals collaborating to create a rising tide that lifts all competing boats. But getting there often isn’t easy, as doing so frequently requires payers and providers to overcome trust barriers that have historically frayed their relationships.
Often, a third party is needed act as the intermediary between payers and providers, delivering efficiency, predictability and consistency in VBR programs while creating an ecosystem that aligns payers’ and providers’ financial goals with patient outcomes. While trust does not require full transparency among rivals, it does necessitate that payers and providers develop enough confidence in each other’s intentions to make technology investments for their mutual benefit.
