The Journey to Value-Based Care: No Longer in Death Valley, But Still Stuck in the Wilderness

Kent Locklear, MDTransitioning traditional healthcare to value-based care models hasn’t been easy. People are reluctant to embrace change, especially when it comes to something as important as caring for our patients’ health.

Think of this value-based care transition like a cross-country journey from Los Angeles to New York City. It’s a long haul that begins with battling everyone else on clogged freeways to discover a clear path out of the congestion and on the road to our ultimate destination.

Where are we now? Some may say we’re stuck in Death Valley…not even out of California, with many providers still struggling to comply with mandates and feeling like they are no longer able to focus on delivering care. In reality, we’re further along than that – perhaps somewhere in the Colorado wilderness ready to use a new set of tools that will put us back on the road to success.

As with all journeys, everyone uses a different set of travel tools based on our knowledge, experience and the vehicles in which we’re traveling. There are core essentials we’re all using – maps, vehicles, and motivation to get us to the destination – but those items are vastly different based on our individual circumstances, travel budgets, and needs.

We all need a vehicle for the trip. Some of us with lighter loads can utilize high-performance sports cars to make the trip as fast as possible, while others who need to carry more items might be in a large RV. For instance, a smaller physician practice with a lighter patient data load can deploy a cloud-based solution that’s easy to scale up and down to meet their needs, while a larger practice or network may require an IT team to implement and maintain a more complex solution. The journey may even require trading in the current vehicle for a better performing one while on the road given the importance of the journey.

A key tool for navigating the journey to value-based care delivery is a well-defined map of the road ahead. Some folks have modern technology, like an advanced GPS, which automatically calculates turns and warns of slowdowns and detours that need to be taken to keep on a path to the destination. In value-based care, these advanced tools include predictive analytics, risk stratification algorithms and cohort managers that enable care management teams to intercede sooner with better patient outcomes. Others may still be using the equivalent of outdated fold-out paper maps that rely heavily on human intervention (which has its limits) to decipher the best possible ways to move forward. In today’s complex environment, investing in a healthcare GPS is critical, as it helps the driver and navigator(s) chart the safest, most effective and efficient course toward successful value-based care.

Finally, incentives are necessary to keep moving forward. This long journey was not anticipated, even as recently as a few years ago, so education, engagement and alignment are keys to a successful journey. Being “penalized” for taking an alternative route and getting lost on a side road isn’t fun nor fair, but does happen as the healthcare industry experienced with meaningful use mandates and will experience with the rapidly approaching challenges of MACRA beginning in 2017. Keeping the incentives clearly defined and readily attainable will help keep us on the main interstate with our eyes focused on the positives at the end of the journey.

The questions like “where are we going?” and “are we there yet?” will not go way anytime soon. The destination is still off in the distance. Fortunately, we have been making steady progress forward in our journey to value-based healthcare. With the new MACRA final rule, it feels like we are back in the wilderness again, but it’s just a temporary detour. Working together, we will complete the journey to value-based care; it just takes the right roadmap with the proper tools and motivation to make our trip a successful one.

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