Value-Based Approach Grows More Important in Healthcare
Tina Graham, VP of revenue cycle management at Greenway Health, talks about how technology is impacting value-based care.
- Earlier this month, Greenway Health announced that its electronic health records (EHR) platforms for National Committee for Quality Assurance (NCQA) patient-centered medical home (PCMH) are prevalidated to foster national care coordination. Its SuccessEHS platform was also highly ranked to support patient-centered medical homes.
In an interview with RevCycleIntelligence.com, Tina Graham, the vice president of revenue cycle management services at Greenway Health, spoke about how technology is evolving in health care, the importance of data sharing and how value-based systems are boosting revenue.
According to Graham, PCMH participation gives providers access to incentives that can significantly boost revenue. Providers must qualify for incentive payments, and electronic health records (EHR) with a high number of auto credits is a substantial advantage in PCMH qualifications. This all leads health care organization to push for technology innovations.
A study of 20 PCMH projects found that through technology innovations, a number of benefits can be achieved. These include:
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• 40 percent reduced hospital admissions
• 30 percent improved population health or provision of preventive services
• 25 percent improved access to care
• 20 percent improved patient satisfaction
• 15 percent reduced hospital readmissions.
A PCMH is much like an ACO in consolidating patient care, with the primary physician leading the care team. They differ in that an ACO consists of multiple coordinated practices. Ultimately, it’s all about care coordination, and EHR integration is central to both.
“Supporting value-based programs is necessary for financial success in the changing landscape of health,” Graham said. “Payers of all kinds continue to move rapidly toward payment programs that emphasize improved health outcomes and population health. Fee-for-service is on the way out, and value-based is its replacement. Supporting these programs isn’t just important to providers; it’s important to patients for whom quality and outcomes of care improve and for payers that see the cost of care better contained.”
She went on to say that systems like EHR play a key role in moving patient data from paper to electronic files, which means it can be securely transmitted rather than simply stored. The vast majority of providers are now on EHRs and the majority of patient data being generated is now in a shareable form. The overall benefit of accountable care organizations and similar programs is that they leverage electronic data for care coordination that was simply impossible before.
It is crucial that providers, payers and vendors work together to meet the demands of health care consumers that are now rooted in value-based solutions. This is going to improve the health of the nation, both individuals and as a group.
“It’s this concept of ‘making a difference’ that brought our customers, and us, into this field in the first place, and it’s exciting to see it happening more and more each day,” Graham said.
