Employers and their benefits consultants are increasingly embracing value-based reimbursement models as they – along with provider organizations, commercial payers, and government programs – seek more ways to improve health outcomes while reducing costs.
A key success criteria of these value-based care (VBC) initiatives depends upon the technical infrastructure that is needed to support these programs. These VBC networks should be able to:
- Enable modeling of contracts using a contract builder approach
- Enable reimbursement for participating organizations
- Digitize unstructured data
- Compile a 360-degree patient Longitudinal Health Care Record (LHR)
- Facilitate data sharing on a permissioned basis
There are several major trends impacting employers and benefits consultants implementing value-based programs.
Meeting patients' needs
Care in traditional settings such as a doctor's office or medical center will continue to shift to alternative delivery sites. These alternate sites for care delivery will include the home, retail environments, and other locations in the community. CVS, Kroger, Rite Aid, Walgreens, Walmart, and others will open more primary care sites in their stores. These retail-based care clinics now offer vaccinations; testing; screening for viruses, infections, and pregnancies; and treatment for minor illnesses, injuries, and skin conditions.
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