Value Based Approach In Healthcare

With healthcare spending steadily on the rise in the United States, healthcare payers are beginning to make the shift from volume-based to value-based payment regimes. The main focus in doing so is to improve the quality of care while reducing the cost. One type of value-based approach is an Accountable Care Organization (ACO), which is defined as a “group of healthcare providers who agree to share responsibility for the quality, cost, and coordination of care for a defined population of patients.” There are three core features of the ACO model. The first is that the ACO consists of a strong base of primary care health provider organizations; the second is that performance measurement is designed to support ongoing improvement in patient care
First and foremost, executing a data governance strategy early on is critical. Administrators should determine what information is necessary and why it is needed sooner rather than later. From there, the hospital can concentrate on the data that need to be gathered, as well as the information processes that will have to be managed in order to reach the anticipated outcomes. Establishing a centralized repository to house the data is another step that should be taken beforehand. However, a data warehouse alone is not going to be enough; the warehouse needs to be built on a relational database that is able to pull data from multiple systems and then integrate, sort, and analyze the data in a quick and easy manner. In order for real-time reporting to be possible, the data need to be readily available, so having the ability to retrieve the information in various formats is also ideal since reporting purposes tend to
An EDW assists in making this possible by facilitating with the trending and surveillance of data. In regards to infection control, better analysis of administrative and clinical data will help the hospital to gain more clarity into hospital-acquired infection rates and any associated costs. There are certain clinical infection surveillance systems that can also be implemented in which surgical procedures, pharmacy orders, and lab results can be analyzed in a real-time manner to help identify, manage, and control infection. From there, risk managers and clinicians can more easily identify any significant risk points. By taking on a more proactive risk management approach, staff members will be encouraged to positively collaborate with one another, and teams will hopefully come together to work towards improving overall patient care and