For many health insurers, top clinical priorities are things like closed care gaps, improved HEDIS measures, completed annual wellness visits, avoided emergency room visits, and reduced inpatient admissions. Payers invest in administering physician incentives and risk contracts that promise to deliver on these metrics. Delivery systems and physician practices respond with integrated care models that support the highest risk segments of the population.
- With digital tools, the expansion is far beyond the 5% of the population that drives 50% of the cost and the activities conducted at traditional sites of care. Digital health can lay an exciting framework for a new chapter in value-based care, one that focuses much more strongly on day-to-day care outside the doctor’s office and outside the hospital.
- As an industry scratched the surface on this aspect of care through telephonic disease management and team-based integrated care. The truth is value-based care has been missing the tools needed to deliver day-to-day support on health.
- Once they form a strong human connection, consumers engage for a long time across multiple modalities, relying less and less on human support throughout their journey. The long-standing goal of value-based care has been the Triple Aim: improve the health of populations, lower per capita costs, and improve the patient experience.
- The industry is exploding with digital solutions, all with transformational promise. The platforms that win are the ones that consumers use. Consumerism is simple that way. It’s easy to get lost in all the complexity of interoperability and combining sources of data from electronic medical records to claims to social determinants.
- Whether shared savings, bundled payments, or full risk, consumer engagement should take center stage in value-based arrangements. The next chapter of value-based care should measure engagement. The full scope of human and digital activity together, both synchronous and asynchronous should be included to unleash the power and convenience of digital tools to move the needle on value-based care.