Value-Based Reimbursement Contracts Now Account for 26% of Hospital Revenue, KLAS Finds

What You Should Know:

– Value-based reimbursement (VBR) contracts now account
for 26% of hospital revenue, according to a new report from KLAS research and
CHIME.

– Report reveals providers are looking first to their
electronic health record (EHR) systems to drive PHM, and are most interested in
investing in new healthcare information technology (HIT) when they know there
is a clear ROI. 


With value-based reimbursement (VBR) adoption slowing, healthcare providers are searching for ways to manage risk and achieve ROI on population health management (PHM) solutions adoption, according to a new report from KLAS Research and CHIME – the College of Healthcare Information Management Executives. The new report, issued, reveals that providers are looking first to their electronic health record (EHR) systems to drive population health management (PHM), and are most interested in investing in new healthcare information technology (HIT) when they know there is a clear ROI.  The findings were based on findings from KLAS Decision Insights, the KLAS 2019 Population Health Management Cornerstone Summit, and CHIME’s 2019 HealthCare’s Most Wired data.

Value-Based Reimbursement in 2020: How Far Have We Come?

VBR contracts now account for 26% of hospital revenue. Fee-for-service still outpaces VBR, and over time, the lack of significant progress toward VBR has eroded healthcare organizations’ confidence that the change will happen in the near future. The biggest factors limiting the adoption of VBR are uncertainty that an ROI will be achieved and a lack of needed infrastructure.

How Is Technology Being Used to Support VBR?

Once organizations decide to invest in technology to help
with VBR, they generally turn first to their EMR. Though provider organizations
may not ultimately choose their EMR for certain population health management
(PHM) needs, EMRs are almost always considered, due to (1) assumed integration
with EMR data; (2) anticipated cost savings; and (3) increased ease of access
to PHM data in the EMR.

EMRs are slightly less likely to be used for administrative
and financial reporting—EMRs have historically struggled to provide the nuanced
views needed in these areas, so organizations often opt for third-party
solutions that provide additional analysis, visualization, and ad hoc reporting.
Third-party solutions may be used on their own or in conjunction with EMR
functionality.

Organizations invest in HIT when there is a concrete ROI

Solutions that help organizations identify and act on care
gaps see some of the broadest adoption as they can be helpful with just about
any VBR contract. Once a gap is identified, organizations need to reach out to
the patient and close it, so patient engagement tools are also highly sought
after.

Functionality is a significant driver in PHM purchase
decisions

Healthcare organizations are looking for enterprise EMRs and
broad BI platforms capable of tackling a large swath of their PHM and
VBR-related functionality needs (e.g., root cause analysis, A/B testing, etc.).
In this quest for consolidation, organizations are seeking to eliminate ad hoc
interfaces and replace vendors who haven’t delivered on functionality or
quality.

“Providers are trying to find positive ROI on their population health management investments,” said Adam Gale, president of KLAS Research. “This report offers a useful roadmap for how they can meet that challenge.”

For more information about the report, visit https://klasresearch.com/report/value-based-reimbursement-2020/1705

Top 3 Priority Areas for Healthcare CIOs in the Age of COVID-19

Top 3 Priority Areas for Healthcare CIOs in the Age of COVID-19

What You Should Know:

– In the age of COVID-19, healthcare CIOs cite interoperability,
cybersecurity, and operationalizing SDOH data priorities as top three priority
areas, according to the third annual LexisNexis focus group of CHIME
executives.

– The survey results also highlighted the importance of
a team approach with support across the organization in helping CIOs
achieve the vision of connected healthcare. 

The Health Care business of LexisNexis® Risk Solutions announced
the results of its annual
focus group
, comprised of over 20 healthcare IT executives that are members
of the College of Healthcare Information
Management Executives (CHIME).
The focus group participants accepted more
accountability than in previous years to provide the safe and
reliable technology tools necessary to deliver high-quality, connected,
and cost-effective care. The survey results also highlighted the importance of
a team approach with support across the organization in helping CIOs
achieve the vision of connected healthcare. 

In light of the COVID-19
pandemic, data sharing and security to using data analytics to help vulnerable
populations – have become more urgent in light of the pandemic challenges. For
example, recent months have illustrated the need for data access to inform
decisions about population health, wellness and care capacity.

The surveyed healthcare CIOs identified three main priority
areas:

1. Managing interoperability: Members acknowledged
challenges amid the surge of digital touchpoints, such as mobile phones, smart
devices and remote services. Goals include a common patient identifier to combine
and verify disparate patient records for a true health information exchange.

2. Bolstering cybersecurity: Members are confronting
new cybersecurity risks, confusion over who bears the ultimate responsibility
for patient data, and the competing goals of seamless user experience and data
safety. To address that final challenge and strike an appropriate balance,
executives are moving to multifactor authentication strategies for optimal user
workflow and security.

3. Integrating Social Determinants of Health (SDOH):
As the pandemic has highlighted, incorporating SDOH
data is a vital, immediate requirement for improving the delivery of patient
support and value-based care, and ultimately, outcomes. Executives shared SDOH
implementation challenges, including data aggregation and operationalization
within IT and EHR systems, especially when not utilizing third-party data to
support their efforts. While CIOs previously had not perceived specific
accountability for SDOH data, that changed as its value was demonstrated.

“CHIME’s executive health IT members are approaching evolving patient and industry needs with careful consideration, ingenuity and focus,” said Josh Schoeller, chief executive officer of LexisNexis Risk Solutions Health Care. “Our annual focus group presents valuable insights about how healthcare decision-makers are strategically using technology solutions to overcome hurdles regarding cybersecurity, data governance, and interoperability, all of which have become more urgent during the COVID-19 pandemic. It’s a big challenge but with the right data integration and analytics they continue to make great progress even in the face of the COVID-19 pandemic.” 

To access the group insights, download the report here.