Using Data Analytics to Advance Value-Based Care

Posted on 31st July 2023

Using Data Analytics to Advance Value-Based Care

Value-based care is an exciting proposition for patients who want the highest level of care at a price they can afford. By “patients” do you mean everyone? Yeah. Those guys.

Value-based care is a system that changes the perspective on what people are paying for in medical care. When people go to the doctor, they aren’t there for treatments, they are there to feel better. Value-based care translates that directly into the financial reality of the transaction, from hospital admission all the way to discharge.

With this system, you don’t pay for the treatment, but for the outcome. Not only does it make care more affordable, but it also improves patient outcomes and reduces hospital overhead in the process.

In this article, we take a look at the value-based care concept, and how data makes it plausible.

What is Value-Based Care?

Value-based care ties compensation to healthcare outcomes. Traditional healthcare compensation programs are service based. In other words, a patient comes in, and they pay for every service they receive, regardless of how effective they are.

The idea is to help ensure that patients don’t spend money on treatments that don’t help them, both making healthcare more accessible to the general public, and encouraging hospitals to be more conscientious about the type of care that they provide.

It’s believed that a value-based care system will not only avoid healthcare waste but also focus on proactive services — care that will help prevent patients from experiencing higher-impact medical conditions in the first place. The system advocates for patient needs, and in the process unburdens the entire system.

The Economics of Value-Based Care

It sounds nice, right? Pay for what works. That framework may sound appealing to patients who have long become used to taking loans out to pay for care that didn’t even do everything they needed it to in the first place.

But what about affordable healthcare systems? Contrary to public opinion, hospitals aren’t rolling in money. Their operating costs and liability are enormous which means that many operate on razor-thin margins. How can they afford a system that potentially puts less money in their pockets?

It turns out, scale is everything. The more people that participate in value-based care frameworks, the better risk is ultimately abated. It’s similar to insurance. There will always be customers who have to make claims, just as there will be patients that have more demanding health conditions.

Just as uneventful insurance customers will offset the expense of those that need to make claims, healthy patients allow healthcare to be more affordable for everyone.

An Unburdened Healthcare System

The healthcare system also benefits financially from improved patient healthcare options. While sick people do create revenue for hospitals, that’s not to say that it is financially beneficial for healthcare systems to have a significant number of high-needs patients.

Remember: the overhead cost for providing premium patient care is enormous. Hospitals not only have to invest significantly to care for sick patients but they also run the risk of failing to collect on those payments.

When a sick person accumulates hundreds of thousands of dollars in debt, they aren’t always able to afford the cost. Often, particularly large hospital bills are defaulted on, leaving the healthcare network at a loss.

Healthy patients reduce hospital overhead and improve the odds that all bills will be paid.

It’s that Easy, Huh?

Well, we didn’t say that. Everything about healthcare is hard, and that includes generally good systems like value-based care. As with many things, the start-up is the most challenging. Value-based care depends on preventative treatment.

For example’s sake, let’s say we are starting an all-new value-based care network from scratch. Five thousand people — it sounds like a lot, but it’s actually, from a practical standpoint, not nearly enough—all receiving regular care for the first time.

In the beginning, it will be crazy. Aches, pains. Some people will come in with pre-existing conditions that need a close look. Diabetes. Hypertension. Things that, if left unchecked could morph into serious chronic conditions over time.

For the first few years, the healthcare network could be overwhelmed, both financially and in terms of workload.

But what about ten years down the line? What about twenty? Instead of having hundreds of people with serious conditions, you have a healthy, stable population. Some people will still get sick, of course, but because of all the preventive care, those numbers will be manageable, and the care itself, affordable.

But How Does Data Enter into the Equation?

Data is all about recognizing patterns in the past and making guesses about how they will continue to play out in the future. In the context of healthcare, that can mean helping networks understand what ailments are the highest risks in their community.

It also means finding easier solutions to treating those ailments in the future. Using data for value-driven care, healthcare providers can:

Anticipate risk and
Come up with strategies to reduce that risk in a way that is mutually beneficial to both the patient and the provider.

The Future of Value-Based Care

It’s been said that value-based treatment is the future of healthcare. In fact, there are talks of assuming this attitude for other aspects of healthcare, including pharmaceuticals. With the United States experiencing some of the highest prescription drug costs in the country, many patients welcome the idea of paying only for what works well.

Full, comprehensive healthcare reform is most likely aways away. For now, however, more advanced nursing technology including provides patients with new hope, allowing the system to optimize and strategize care disbursement in a way that is both affordable and effective.