Leveraging data with physicians to drive value-based patient care
Abstract
As the underpinnings of value-based patient care transform the clinical, operational and financial strategies of hospitals and health systems across the country, the foundational structure of the transaction-based traditional fee-for-service (FFS) reimbursement methodology may no longer align effectively with the needs of patients and providers. Whereas providers’ reimbursement has been traditionally unbundled with separate payments for every test, procedure or consultative visit, healthcare is moving towards an approach where reimbursement also reflects the quality and outcomes of care longitudinally over time. This shift poses many operational and organisational hurdles for healthcare providers, who will need to unify the somewhat disjointed needs and perspectives of clinicians, health systems and patients while realigning funding models to reward the required behaviour changes from all participants. To effectively shift to value-based care, healthcare provider organisations will need to develop a collaborative approach with physicians to measure, identify and reduce quality and cost variation, build trust, drive efficient processes and deliver results. This will not be possible if the important clinical, financial and operational stakeholders do not have accurate and accessible clinical data from their electronic health record (EHR) and trusted cost data from their cost accounting application for each patient they serve. The success of hospitals and healthcare organisations in value-based care will depend on their ability to leverage data and engage physicians to drive improvements. In this paper, the experience of Yale New Haven Health System supported via a collaboration with Strata Decision Technology provides a roadmap for health systems to significantly improve care and drive better financial outcomes in both value-based care and FFS settings for the patients we serve.
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Author's Biography
Steve Allegretto is the Senior Vice President of Finance and CFO at LMH Healthcare and Vice President of Finance at Yale New Haven Health, a US$4.5-bn health system with over 24,000 employees located primarily in Connecticut. He has been at Yale New Haven Hospital/Yale New Haven Health for over 33 years, serving in a variety of financial and operational roles. He is a certified public accountant with an undergraduate degree in economics from Fairfield University and a master’s degree in public health from Yale University. He has had various teaching responsibilities at Yale School of Medicine’s Epidemiology and Public Health Program, Quinnipiac University, Sacred Heart University, and currently is an adjunct professor at Fairfield University developing an undergraduate programme focused on healthcare financial management linked to patient value. Steve has a deep interest in demonstrating how the actual application of integrated clinical, operational and financial data drives actual improvement in patient care quality and cost while generating opportunities for value innovation and venture creation. He has a proven history in partnering with physicians and operational partners to implement value-based payment models that improve value for the patients he helps to serve.
Barbara Mccloskey is a registered nurse, DNSc and Finance Clinical Coordinator at Yale New Haven Health System.
Alon Ronen is an active cardiologist in a private practice within the Yale New Haven Health — Northeast Medical Group. He has served in multiple leadership roles, including President of the medical staff of St. Vincent’s Hospital in Connecticut, and is now the co-director of the Cardiology Shared Value Program for the Northeast Medical Group/HVC. Alon obtained his undergraduate degree from Stony Brook University and medical degree from the Medical College of Pennsylvania. He did his medical residency and cardiology training at the University of Massachusetts, where he also served as Chief Fellow. He is an Associate Professor at the University of Bridgeport College of Health Sciences and enjoys teaching students, residents and cardiology fellows along with his clinical practice.
Kim Pont is Innovation Scientist at Yale New Haven Health System.
Dan Michelson is the CEO of Strata Decision Technology, where he aims to ensure the company delivers on its mission to help heal healthcare. With almost 30 years of healthcare experience, Dan has been one of the industry’s important thought leaders in developing the decision support, financial planning, electronic prescribing and electronic health record markets, including serving on the Certification Commission for Healthcare Information Technology and co-authoring the books Margin + Mission: A Prescription for Curing Healthcare’s Cost Crisis and The Electronic Physician. Under Dan’s leadership, Strata Decision Technology has been recognised as one of the fastest growing companies in the nation by Inc. Magazine, one of the best places to work in healthcare by Becker’s Healthcare, and as ‘Best in KLAS’ for the highest customer satisfaction by KLAS Enterprises for the last six years. Dan has been a two-time finalist for Illinois Technology CEO of the Year. Prior to joining Strata, Dan provided strategy and process redesign consulting for many of the leading hospitals and health systems in the United States and served in leadership roles for Baxter Healthcare and AstraZeneca. Dan co-founded HackHunger™, a collaboration of tech companies working to crack the code on hunger. Dan earned his BS in Finance from Indiana University and his MBA from DePaul University.
Keith B. Churchwell is Senior Vice President of Operations and Executive Director of the Heart and Vascular Center and Transplantation Center for Yale New Haven Hospital, Clinical Service Coordinator for the Department of Medicine at Yale New Haven Hospital and Associate Clinical Professor of Medicine at the Yale School of Medicine. Born and raised in Nashville, Tennessee, he obtained his undergraduate degree from Harvard University and medical degree from Washington University School of Medicine. He spent his formative training years, including his cardiology fellowship and a chief residency in medicine, at Emory University Medical School and Affiliated Hospitals, then spent 12 years in private cardiology practice before joining Vanderbilt Medical School as full-time academic faculty in 2006 (he became a member of the clinical faculty at Vanderbilt in 1999).
Citation
Allegretto, Steve, Mccloskey, Barbara, Ronen, Alon, Pont, Kim, Michelson, Dan and Churchwell, Keith B. (2019, December 1). Leveraging data with physicians to drive value-based patient care. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 4, Issue 2. https://doi.org/10.69554/REWH4882.
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