Successful value-based care (VBC) models such as the Medicare Shared Savings Program (MSSP) and Medicare Advantage (MA) emphasize increased risk sharing between payers and providers. As they enter more risk-sharing models, payers must find ways to better coordinate with providers to manage risk by identifying cost drivers and closing gaps in care.
By fostering trust through transparency and empowering providers with actionable insights, payers and providers can work together more effectively to achieve clinical and financial goals while delivering high-quality care.
Trust between payers and providers begins with transparency. Value-based care aims to realign incentives in the healthcare system, shifting them away from a focus solely on the volume of care to the value of the care provided, and the patient outcomes. But that is a significant shift for providers who have long functioned in the fee-for-service world. There is understandably trepidation and uncertainty from providers about how to succeed in VBC, particularly when the model or concepts are new. Sharing clear information on the metrics and incentives, and regular reporting on individual providers’ performance in the model, engenders trust and improves communication.
Your software should make it easy to communicate:
Cedar Gate’s analytics dashboards offer providers a clear visual of the key metrics and performance indicators within a risk-based program. Our data capabilities also make it easy to drill down into specific metrics and measurements to identify opportunities for improvement. AI-powered predictive models can surface opportunities for closing care gaps, increasing revenue, and hitting specific targets throughout the year.
Access to underlying data tables enables providers to independently verify the data, further building trust and empowering them to act to meet their goals. Ultimately, payers play a pivotal role in establishing a collaborative environment where both parties work together on common objectives.
Empowering providers with actionable insights is essential for driving meaningful change in risk-based models. When payers give provider partners focused and relevant information – insights – those providers can create workflows and care team processes to address the most important aspects of patients’ care needs. With Cedar Gate’s fully integrated analytics and care platform, information moves seamlessly from an analytics dashboard to the EHR, providing clinical decision support at the point of care for more cohesive care delivery.
When insights come from comprehensive data sets, including both clinical and claims data, providers get a more holistic view of patient health and care gaps. For example, comparing clinical data from EHRs with claims data can highlight discrepancies and enable more effective care gap closure, leading to better outcomes for everyone.
Navigating a risk-based future will not be easy. But when payers and providers can effectively collaborate with a foundation of trust and transparency, it’s easier for everyone to work toward shared goals of better quality and lower cost care. Cedar Gate’s integrated analytics and care tools help create empowered provider networks to more effectively deliver high-quality, value-based care to patients. Request a demo to get started today.
