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Like every health care organization, your struggles with data may appear never-ending. Like money, there never seems to be enough of it. In this article we’ll take the mystery out of how to realistically gauge your data needs, identify the links between what you want to accomplish as an ACO or medical group in value-based payment models and those data requirements, and help you target your data efforts.
When providers were focused on meeting patient volume targets, operations systems like billing and scheduling provided an adequate basis for tracking volume and revenues. But the shift to Value-Based Care (VBC) demands accountability for both outcomes and costs, which means that you need more evidence for all patient interactions. Your participation in payment models should not be opportunistic. Instead, it should be predicated on an understanding of the vulnerabilities and strengths of your patient populations and issues that could derail your budget. The right data gives you the insight you need to avoid cost overruns and plan your VBC strategies.
It’s no secret, however, that ACOs, physician organizations, and small to moderate medical groups are often the most data poor. Less well understood is the fact that calculations defined in VBC demand different data and novel approaches to organizing that data for analysis. The following three approaches, used separately or progressively, will move you from data poor to sufficient and enable you to meet the competition.