2024 Outlook: Five key analytic capabilities shaping VBC

By Milliman MedInsight

22 January 2024

The healthcare industry is undergoing a transformation, largely driven by value-based care (VBC), artificial intelligence (AI), and digital transformation. These trends, which gained significant momentum in 2023, will continue to shape the healthcare industry in 2024 and beyond. As organizations aim to improve efficiencies and the delivery of care, the increasing use of analytics emerges as a pivotal tool in supporting their success.

Healthcare organizations, however, continue to face a critical challenge — ensuring the availability of high-quality data for analysis and decision-making. Persistent issues with data fragmentation, inconsistencies, and inaccuracies all pose significant obstacles that not only hinder an organization’s ability to assess and compare outcomes effectively but also impede digital transformation and value-based care advancements. In VBC models, where reimbursement is tied to the quality and effectiveness of care, accurate and trustworthy data is essential to measure performance, track progress, and drive continuous improvement.

Below are five analytic strategies that can empower organizations to increase data-driven insights, optimize care delivery, and improve patient outcomes within an evolving VBC landscape.

1. Establish a robust data engine

To thrive in the era of value-based care, organizations must undergo a digital transformation. The first crucial step in this transition is establishing a secure and reliable cloud-based infrastructure capable of handling large volumes of data. By implementing a unified analytics platform, organizations can create a seamless integration among providers, health plans, and members, fostering shared accountability and driving improved healthcare outcomes. Leveraging advanced analytics empowers organizations to make smarter decisions, while the scalability and flexibility of cloud technology provide added benefits.

2. Gain comprehensive insight into the total cost of care

To succeed with at-risk contracts, healthcare organizations need to have a clear understanding of their patient population and the associated risks. This includes identifying high-risk patients and implementing care management programs to proactively address their needs. Data analytics can be used to identify trends and patterns in patient data, which can help providers develop targeted care plans that improve outcomes and reduce costs. In risk-based arrangements such as bundled payments, shared savings, and full health plans, understanding the cost of care is of utmost importance for organizations. By aggregating spend across multiple practitioners, organizations gain visibility into the patient’s entire care journey and the exposure in a risk-based contract.

3. Ensure effective contract performance monitoring

As organizations embark on new VBC contracts, they encounter significant challenges in their quest to lower costs and enhance health outcomes. This calls for a fresh perspective on revenue and risk management. To effectively tackle these challenges, organizations must prioritize detailed analytic reporting to track progress and ensure the achievement of targets.

To remain on the right path, organizations need a dependable, transparent, and current analytics infrastructure that closely aligns with the requirements of their VBC contracts. This infrastructure empowers organizations to evaluate their contracts, evaluate the performance of their risk-sharing partners, and closely monitor overall performance.

4. Harness the power of AI and machine learning

Harnessing the power of artificial intelligence (AI) can significantly streamline the management of complex data sets and modeling, saving valuable time and resources that would otherwise be spent on data collection, cleansing, and organization. AI enables organizations to analyze large volumes of data rapidly and flexibly, providing quick answers to critical questions.

To maximize the performance and learning capabilities of AI, it is crucial to have clean and well-implemented data that is properly formatted. AI algorithms thrive when they can access high-quality data that is organized and structured effectively. This ensures that the AI system can effectively process and analyze the data, leading to more accurate and reliable results.

5. Expand your reach through seamless EMR integration

As clinicians enter data into the EMR system at the point of care, it becomes readily available for analysis. EMR data provides a richer dataset that includes not only claims information but also additional details such as lab values and physician notes. This comprehensive view enables a more holistic understanding of patient care and facilitates improved physician engagement. By eliminating frustrating gaps in the care record, EMR data streams enable timelier interventions and enhance the overall quality of care.

Drive healthcare transformation with MedInsight’s VBC Platform

With the MedInsight VBC Platform, organizations can benefit from a best-in-class data warehouse that enables organizations to unlock the full potential of their data and drive meaningful insights for improved decision-making and outcomes.

The benefits of using the VBC Platform include:

  • Seamless integration: We work with customers’ existing systems, such as their EMR (e.g., Epic) to ensure a smooth transition and maximize the value of their investments with our powerful VBC platform.
  • Speed to insights: We have the expertise and experience to provide the necessary insights to drive success in value-based care today. We have a proven track record of meeting customers where they’re at in their journey to value-based care, especially when it comes to EMR integration. We are constantly pushing the boundaries of innovation and regularly introducing new technologies to our offerings that will only be made available through the MedInsight VBC Platform.
  • Flexibility: We provide a wide array of tools and technologies that cater to the specific needs of different user groups, including Information Consumers (VBC Insights), Data Analysts (VBC Analytics), and Data Scientists (DSP). This flexibility enables organizations to gain valuable insights and make data-driven decisions by leveraging:
    • Full MediSpan Rx data tables
    • 70+ methodologies (CCS, HCPCS families, HCCs, etc.)
    • A robust portfolio of industry-recognized benchmarks
    • 1000+ certified measures

Download our eBook Leading the way in value-based care: Best practices for mitigating risk to learn more about our VBC Platform and how it can help you succeed with value-based care.

Contact us to learn more about healthcare data analytics