Meeting the Demands of Value-Based Care with the Veradigm Network

Written by: Cheryl Reifsnyder, PhD and Amanda Cohen, MPH

The American healthcare system has been making the slow but inevitable shift away from the traditional fee-for-service (FFS) payment model. Under FFS, healthcare providers were paid based on the quantity of services provided rather than the quality of those services. FFS incentivized providers to deliver more services per patient and order more tests and procedures, contributing to escalating healthcare costs in the United States (U.S.)

Unfortunately, the increased costs in the U.S. are not associated with improved patient outcomes. When compared to other high-income nations, such as Australia, Canada, and the United Kingdom, the U.S. has the lowest life expectancy, the highest chronic disease burden, and the highest rate of avoidable deaths.

Now, though, FFS is giving way to a new payment model known as value-based care, which compensates providers based on patient health outcomes. Value-based care rewards providers for reducing the burden of chronic disease and helping patients live healthier lives.

To accomplish this, value-based care focuses on improving healthcare quality for patients and preventing problems before they begin. Value-based care's approach to healthcare is proactive rather than reactive. This focus on prevention means value-based care helps cut costs by lowering the need for expensive medical tests, ineffective medications, and unnecessary procedures.

Value-based care has demonstrated numerous benefits for all stakeholders in the healthcare system, from patients to providers to payers. These include lower costs, higher patient satisfaction, and fewer medical errors. Value-based care can also result in better-informed patients who incorporate healthier life habits. Research at the Robert Wood Johnson Foundation reveals that patients who are actively engaged in their healthcare are more likely to manage their health conditions and remain healthy; patients lacking the skills to manage their own healthcare often require more healthcare interventions, resulting in higher healthcare costs.

Physicians focused on value-based care have created tools to help walk patients through different treatment options. These tools translate complex medical jargon and risk statistics into patient-friendly language and images to help patients make more informed treatment decisions-leading to better patient outcomes. With value-based care, patients are:

• Less likely to regret their treatment choices
• More likely to stick to their treatment plans
• Less likely to undergo invasive procedures

Despite its promised benefits, though, shifting to value-based care is not always smooth or straightforward. Value-based care models require numerous changes in the healthcare practice, including different tools, different approaches to patient care, different patient data, and more. Today's healthcare providers are under increasing pressure to improve the quality of their patients' care while simultaneously controlling costs.

At Veradigm, we are committed to helping healthcare professionals make the shift to value-based care. In this article, we introduce the Veradigm Network-a dynamic, open community comprised of Veradigm's internal solutions and external collaborators working together to provide advanced insights, technology, and data-driven solutions. Keep reading to learn three (3) ways the Veradigm Network can help your practice make the changes necessary to successfully navigate the transition to value-based care.

#1. The Veradigm Network facilitates team-based care

Team-based care is an essential component of value-based care. The Veradigm Network supports and facilitates team-based patient care in multiple ways. For instance, Veradigm offers practices a suite of easy-to-use solutions, including the Veradigm Ambulatory Suite, to help streamline clinical and financial workflows. Veradigm's solutions promote interoperability, which is crucial to successful team-based care. Veradigm also helps support improved communication among patients' caregiver teams by leveraging interoperable data sources to facilitate the exchange of patient records, test results, and other data among caregiver team members. Improved communications can lead to less frequent patient hospitalizations, fewer readmissions, and fewer emergency room visits. Using interoperable data sources also helps eliminate repetitive and unnecessary patient tests and procedures by consolidating patient records.

Communication between care team members is further facilitated by Veradigm eChart Courier™, an easy-to-use Veradigm solution that helps save time, office resources, and expense by automating the medical chart retrieval process. Manual retrieval of patient health records is time-consuming and resource-intensive, frequently diverting resources from patient care. By automating chart retrieval, eChart Courier enables healthcare providers to share medical records with other providers, health plans, or other payers in a secure, automated, and seamless fashion.

Automation helps practices:

• Save time: The system does the work of pulling patient charts, allowing practice staff to focus on delivering the best possible care to your patients.
• Increase efficiency: Since eChart Courier operates through the practice EHR, you can seamlessly provide requested patient information without altering your existing workflow.
• Ensure security: Patient information is communicated in an encrypted format so only intended users can view the data.
• Support value-based reimbursement: eChart Courier aids data collection for quality measures that impact reimbursement for a variety of value-based care payment models.

Best of all, eChart Courier is offered at no additional cost to providers. It is available with the Veradigm EHR and the Practice Fusion EHR but is also EHR-agnostic meaning able to be used as an add-on with many other EHR solutions-still at no cost to healthcare providers.

#2. The Veradigm Network can help target patient interventions more effectively

Preventive patient care is another critical component of value-based care, both because it can help improve patient outcomes and because it can help reduce healthcare costs. The Veradigm Network can deliver real-time analytics to help providers target patient interventions and preventive care more effectively. For instance, solutions such as Veradigm Payer Analytics generate data that can stratify patients by social determinants of health (SDOH) community levels and risks, helping practices identify targets for improving patient care.

Veradigm Payer Analytics also generates the real-time visibility practices need to monitor and manage Key Performance Indicators tracking utilization and costs associated with delivery of your value-based contracts. Practices can track data such as emergency department usage, inpatient treatments, or patient readmissions after treatment-data that can help determine the most effective actions to take for improving patient health while lowering the overall cost of care.

#3. The Veradigm Network can help improve patient health literacy

According to the Patient Protection and Affordable Care Act, health literacy is defined as "the degree to which an individual has the capacity to obtain, communicate, process, and understand health information and services in order to make appropriate health decisions." It comes into play whenever an individual interacts with the healthcare system-for instance, when the patient's care team asks them to decide between treatment options or when the patient picks up a prescription from the pharmacy, requiring them to understand the medication's dosage instructions. Poor health literacy is one of the key barriers to delivering effective patient care, making health literacy another essential element of value-based care.

Low health literacy makes it extremely challenging for patients to navigate today's healthcare system, but health literacy remains a struggle for 9 out of 10 American adults. Low health literacy is a particular problem among those with lower socioeconomic status, less education, the elderly, and those receiving publicly financed health coverage.

Low health literacy intersects with value-based care due to its clear impact on patient health outcomes. Research shows inadequate health literacy is commonly associated with poorer health, lower use of preventive care, decreased medication adherence, higher hospitalization rates, and poorer health outcomes. Inadequate health literacy is a stronger predictor of poor health than age, race, income, education level, or employment status. Individuals with inadequate health literacy frequently often struggle with poor self-care behaviors. They are also at greater risk for adverse outcomes such as medication errors, hospital readmissions, and death.

Health literacy is also clearly related to patients' healthcare costs-another element of value-based care. Several studies have revealed that patients with lower health literacy use health services more often than those with proficient health literacy, contributing to greater healthcare costs. One study estimates that inadequate health literacy adds between $106 and $238 billion to annual healthcare expenditures in the U.S. The Centers for Disease Control and Prevention estimates that improving health literacy could prevent nearly 1 million hospital visits and save over $25 billion annually.

One way the Veradigm Network can help support improved health literacy among patients is with our prescription price transparency tool, Veradigm RxTruePrice™. RxTruePrice enables providers to deliver information about patient medications, including patient-specific pricing and coverage information, before patients reach the pharmacy.

The Veradigm Network: Tools to support value-based care

The Veradigm Network can help support providers aiming to improve performance in value-based programs. Our suite of easy-to-use practice solutions can help practices align with the quality improvement initiatives and cost containment interventions present in many value-based payment programs. The Veradigm Network offers assets to help improve patient engagement and patient health literacy; it can also deliver real-time analytics to help you more effectively target patient interventions and preventive care.

Let Veradigm help you make the sometimes-rocky transition to value-based care-and reap the many benefits it promises to deliver to both your practice and your patients. Contact us today to learn more!

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