In this episode of the Insights podcast, we spoke with Dr. Michael Blackman of Greenway Health about health information technology and value-based care.
Q: Where do you see the biggest impacts when you integrate technology into a value-based care model?
A: "Understanding all the patients that a practice or group is responsible for … (For example, technology and data allow us to understand) what percentage of (patients) have had mammograms? If we can do the basic blocking and tackling - the things that we know work and that we know improve people's outcomes, the first question is: what's the population that needs to have a mammogram? Next question is: who's had one? And by extension, who hasn't? And for that group that hasn't, okay, now we get to the hard part. What do you do about it? How do we reach out to them? There's no single simple answer to that question, but (technology provides shortcuts to) getting everybody that basic care that they need."
Q: What are the most important KPIs that you think a practice should be looking at once they have that value-based care model in place?
A: "If you’re strictly thinking about value-based care, the first place a lot of people go to is – well, what are my value-based contracts with my payers? … What are those items on which I'm getting paid? Those set up pretty nicely as initial KPIs, but it certainly doesn't have to be limited to that. Please don't misunderstand - practices getting paid is important. You need a margin to continue to provide care, but there may be other things that are of particular interest to the practice or a given community.
If we think back a couple of years to the very tragic example of the water system in Flint, where there was widespread lead exposure, you might want to track the children that were screened for lead, who hadn't yet been screened? (You're) making sure that you get screening to everybody that needs it.. … So that's just another use of the same type of technology. … There's lots of data, and sometimes the data can become overwhelming, especially if you’re doing home monitoring in some way. We need the computer and algorithms to look at that data and knock it down to the relatively small number of people who need to be called or contacted in some way. There's no possible way that humans could weed through all of the data on a daily basis."
Q: When you get a really efficient and effective value-based care model, is the patient a more active participant in their own healthcare? What does that look like?
A: “The patient certainly becomes a more active participant in their care, and healthcare, as a general rule, is something that is better done with you than to you. So, the more people that are involved in their care, the better they have an understanding of their disease process and how their decisions affect it.'
Q: If we’re a practice and we're looking at starting a value-based care model, where do we start? There are so many steps. Are there resources, tools, anything you could share with our listeners, to lessen that overwhelm that people might face when shifting to a value-based care model?
A: "I think the key is, look at the breadth of options, and then pick something. Not everything, but something, and say, (that) this is where you want to start. … You could do that based on a payer contract. You could do that based on, ‘Hey, I know, as a practice, we have a lot of patients with congestive heart failure, and we have a lot of admissions as a result of that, and that's the disease I want to start with.’ Then figure out, what are the things you want to do to try to address that?"
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The MGMA Insights podcasts are produced by Daniel Williams, Rob Ketcham and Decklan McGee.
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