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By Sarah C. Threnhauser, MPA

The adoption of new technology is an evolving process that is never quite finished—as the market changes, so do technology needs. The shift to more reimbursement based on performance or value is no exception. What technology and data analytics an organization needs are dependent on where they are on the spectrum of value-based care. As value-based reimbursement (VBR) models require more assumption of downside financial risk, there is a need for more sophisticated functionality and informatics.

Laurie Nelson, Group Product Manager for Analytics, Relias presenting at The 2018 OPEN MINDS Technology & Informatics Institute

The VBR-driven spectrum of technology needs was the focus of the discussion in the session, Technology Solutions For Value Based Care: How To Make The Best Decisions Relative To Your Market & Business Positioning, at The 2018 OPEN MINDS Technology & Informatics Institute. In the session, Laurie Nelson, Group Product Manager for Analytics, Relias; Kevin McDonnell, Senior Director, Enterprise Account Management-Population Health and Healthcare Analytics, Relias; and Michael Garrett, Chief Executive Officer, Horizons Mental Health Center, discussed how the use of technology evolves with an organization and how organizations can prepare for the inevitable shift to value-based reimbursement.

Mr. Garrett from Horizons Mental Health Center provided a great illustration about how the market, and reimbursement, shapes an organization’s technology strategy. His organization, a Kansas-based behavioral health provider organization that serves over 6,000 consumers and their families a year, has made several investments in new technology as the Medicaid system in Kansas has evolved.

As the state began shifting to managed care in 2007, technology for improving managed care efficiencies was key. Horizons shifted away from transcribing dictation and paper records and added an electronic health record system.

Then, in 2015, when the state began planning for a health home program, Horizons had to think about care coordination and population health management. They needed technology to facilitate the care coordination process, and to maximize outcomes, their team needed analytics to identify at-risk consumers and the best interventions for those consumers. Both activities require sharing data with payers and other provider organizations. To make sharing and analyzing data possible, they began working with Relias to develop a population health management platform and enhance their data analytics capabilities.

As they moved through this evolution, Mr. Garrett explained that their organization’s overall strategy for technology purchases focused on three questions:

  1. Does the technology create operation efficiencies for both consumers and the organization itself?
  2. Does the technology help to promote financial efficiencies and automation, or help to produce more accurate reporting?
  3. Does the technology aid in clinical practices by helping to track outcomes and processes or aiding in documentation processes to meet payer standards?

Regardless of where an organization’s reimbursement is on the VBR continuum, these three questions are great guides to technology planning and technology purchases. But it demands a willingness to change at the speed of the market. Or, as Ms. Nelson explained, with the health care system changing along with the shifting spectrum of value-based care, provider organizations will need to “move out of their comfort zone” when it comes to the use of new technology and analytics

For more on what it takes to master the transition to value-based care, check out these resources in the OPEN MINDS Industry Resource Library:

  1. The Enablers Of Competitive Advantage
  2. Tech Capabilities In An Era Of Integration & Value
  3. The Moving Target-Best Practices In ‘Complex’ Care Management
  4. Mapping Performance To Manage Value: The Clinical Data You Need To Manage The Risk Of Value-Based Reimbursement
  5. Are Your Financial Systems Ready For Value-Based Reimbursement? Managing Risk, Data Modeling & Financial Projections For VBR Success
  6. What Will Mental Health Treatment Look Like In The Years Ahead?
  7. The Digital Decision Crossroads
  8. Preparing For The Very Glacial VBR Rollout In Some Markets
  9. HIE 3.0?
  10. Preparing For Value-Based Reimbursement-Even Before The Contracts Are Signed

And for the deep dive, join us in June in New Orleans at The 2018 OPEN MINDS Strategy & Innovation Institute for the seminar, Succeeding With Value-Based Reimbursement: An OPEN MINDS Executive Seminar On Organizational Competencies & Management Best Practices For Value-Based Contracting. And, to assess your organization’s readiness for value-based care, Elite OPEN MINDS Circle members download our Value-Based Reimbursement Readiness Assessment. This web-based self-assessment for value-based reimbursement readiness is focused on the scoring organizational and technical competencies needed to make the transition to VBR successful.

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