At the heart of our VBC transformation lies the crucial role of data. Harnessing the power of data enables us to address disparities, identify barriers to care, and deliver patient-centered solutions that drive better outcomes. Data-driven approaches are shaping the future of value-based care in critical ways, and organizations need the right tools to succeed in their own VBC journey.
The Centers for Medicare and Medicaid Services (CMS), as well as commercial payers and providers, understand that health equity is a significant challenge in our current system. Providing everyone access to the same high-quality care – regardless of race, socioeconomic status, income levels, health, or care needs – is imperative. Initiatives from CMS, such as ACO REACH and the new Primary Care Flex model, heavily emphasize the need to address health inequity.
To do this, healthcare delivery organizations must have data tools that can capture information like social determinants of health (SDoH), Area Deprivation Index (ADI), and other potential barriers that affect a person’s ability to get the care they need. This information comes from multiple disparate sources, making it difficult to capture and use efficiently. But the right technology can normalize, cleanse, and enrich all this data, creating opportunities for payers and providers to design plans and outreach to meet these patients wherever they are, with the right resources based on their needs.
Embracing patient-centered care requires a comprehensive understanding of individuals’ needs and challenges. A more holistic approach, that incorporates information beyond traditional clinical data for a 360-degree view of patient needs, is the key to closing gaps in access and quality.
Data serves as the cornerstone of success in the next phase of VBC. Immense volumes of data on patients hold invaluable insights for delivering better care. However, unlocking these insights requires stakeholders—payers, providers, and employers—to have access to comprehensive data sets. Stitching together data from disparate sources remains a significant challenge, but it’s a crucial step towards creating patient-centric care plans and improving decision-making processes.
Technology plays a pivotal role in improving care access, outcomes, and cost-effectiveness. Cedar Gate’s data management tools seamlessly ingest multiple data sources, normalize information, then enrich it and stitch it to each member within a patient population. That information flows into our proprietary data lake, becoming a single source of truth that provides a cohesive view of each patient’s profile can enhance care quality and efficiency.
With streamlined access to these diverse data sets – including claims data, electronic health records (EHR), SDOH data, and area deprivation index (ADI) data, and more – healthcare organizations gain a more complete understanding of patients’ needs.
Our Value-Based Care Analytics application, equipped with clean, normalized data from our data lake:
Our integrated Analytics and Care solutions translate these data insights into actionable steps for care teams, empowering them to deliver more personalized, evidence-based care.
Payment technology also plays a crucial role in managing alternative payment models within VBC programs, such as the Medicare Shared Savings Program (MSSP), capitation, or prospective bundles. A fully integrated system allows information to flow seamlessly from Analytics and Care applications to the Payment tools, ensuring accurate reimbursements and efficient funds flow in alternative payment models.
Achieving health equity and improving access to care in value-based care settings begins with data. By embracing technology solutions and leveraging comprehensive data sets, healthcare organizations can drive meaningful change, enhance patient outcomes, and pave the way for a more equitable and accessible healthcare system. Cedar Gate’s end-to-end platform tailored specifically for VBC is key to succeeding in a data-driven future that prioritizes the well-being of patients and communities.
