Determining quality over cost, meeting the triple aim, and employing analytics tools are key to success.
As U.S. healthcare pivots from volume to value, spurred on by MACRA and other payer imperatives, participants at a recent HealthLeaders Media Roundtable offered their perspectives on just how to measure value.
"The triple aim objectives are a really great framework for thinking about value," says Mouneer Odeh, vice president of enterprise analytics and chief data scientist at Thomas Jefferson University and Jefferson Health in Philadelphia, Pennsylvania.
"The patient experience is obviously a critical driver of that—the health outcomes and then, obviously, the financial cost."
A key enabler of measuring value is a data-driven culture and analytics tools, Odeh says. "There's such a huge gap between our current capabilities and the potential that exists." Lending perspective to Odeh's opinion are his previous stints directing analytics at firms in other sectors of healthcare, such as pharma, life sciences, and diagnostics.
"If we don't understand the value of what we're providing to our patients, Medicare is going to take back X number of dollars for every patient that we serve," says Stephen Allegretto, vice president of analytic strategy and financial planning at Yale New Haven Health in New Haven, Connecticut.
"We've tried to look at value as quality over cost," Allegretto says. "We can't yet measure the process outcome for every patient population yet … but you have a starting point."
"Value to a patient or to someone who is in a Medicare Advantage plan may not be whether or not I can get the lowest-cost hip or knee replacement and where I can get it, but it may be how to avoid the surgery altogether," says Sam Bagchi, system chief quality and medical officer at Presence Health in Chicago.
"There's nothing magical about a hospital. I am a hospitalist; I spend a lot of time in hospitals. There's very few things that you can't do somewhere else."
Bagchi notes that an inevitable effect of the pivot to value is that "hospitals are closing. You're winding down inpatient utilization."
All participants agreed that healthcare has to continue to find ways to reduce costs, and that analytics technology is a key enabler of this trend.
View the complete HealthLeaders Media Roundtable report, "Creating the Data Foundation Needed for Value-Based Care."
Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.