MGMA19 Session Spotlight: Tools to tackle the value-based disruption of healthcare

Insight Article - July 23, 2019

Population Health

Data Analytics & Reporting

Chris Harrop
When it comes to what’s disrupting the lives of medical practice managers, there’s one clear answer according to Edwin Miller, MBA, chief product officer and co-founder, Aledade.

“I spend all of my time on the transition to value-based care,” Miller says. “I think having some strategy to move from fee-for-service to value is top of mind for everybody — being able to take risk. There’s a lot of entry-level ways to do that, all the way up to taking downside risk.”

That prospect can be a bit daunting for some practice leaders, especially if the organization has not already built a solid foundation for collecting, measuring and digging into key data points, he notes.

“You have to be really good with data and analysis of what’s going on. You can’t take risk without … having some predictive analytics to do that,” Miller says.

This is doubly challenging since most tools that a practice leader might invest in don’t just work off the shelf. “This are hard things to buy, because they’re so tuned to what the unique characteristics of each practice [are],” Miller asserts. There are population health tools that offer lots of dashboards and lots of data, but Miller notes that practice leaders should be prepared to interpret that data to make decisions that reflect the true nature of the data.

One of the ways to move beyond the skill sets needed for fee-for-service is to build workflows that align with your value-based care goals that help your practice get the whole view of a patient’s care story. Today’s tools, Miller argues, help deal with the episodes of care that happen with your providers, but they often miss a larger continuum of care for patients.

“They go to the ER, they're getting discharged from the hospital, they're having specialists do things to them that you don't know about as a primary care doctor,” Miller says. “Benefiting from that situational awareness around all the things that are happening to the patients that you aren't seeing and being able to trigger workflows around those — those are the tools that I think are beneficial to move into value-based care.”

Miller admits that there is still ground to be covered to make those kinds of changes stick, mainly in standardization and interoperability. “Having established, repeatable workflows [is important],” Miller says. “Is it really repeatable to go to 15 portals and pull down a couple of patients at a time and figure out what to do?”

Miller — along with Emily Maxson, MD, chief medical officer, Aledade — presented “Tech Tools to Make the Most of Annual Wellness Visits,” on Monday, Oct. 14, at MGMA19 | The Annual Conference.
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About the Author

Chris Harrop
Chris Harrop
Senior Editorial Manager MGMA

Chris Harrop, senior editorial manager, MGMA, serves as editor of MGMA's flagship print publication, MGMA Connection magazine, and oversees various association content publications while also serving as a contributing author for the organization. Prior to MGMA, he was managing editor of multiple news organizations in the Denver metro area. Email him.

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