As the healthcare industry continues its transition to value-based care (VBC), most organizations struggle to formulate a clear and concise analytics strategy that will support this transition. The latest report from Chilmark Research, “The Necessity of a Value Chain Model for Healthcare Analytics,” provides healthcare organizations (HCOs) a model for building an analytics strategy that aligns with their VBC needs as well as a set of requirements for their analytics platforms in order to insure a return on investment (ROI). The report provides strategic insight and guidance to anyone interested in the role that a defined analytics strategy and robust analytics platform can play in accelerating an HCO’s ability achieve the goals of VBC. HCOs, payers, healthcare IT vendors, consultants, investors, and others will all benefit from this in-depth report.
The industry’s ongoing shift away from its fee-for-service (FFS) business model requires HCOs to provide high-value and not high-volume healthcare services for the communities they serve. Concurrent with this shift is the further digitization of care processes to improve the patient experience and optimize services. This requires a heavy reliance on data analytics to garner a deep understanding of how the HCO operates and the patients it serves. However, the industry is struggling to put their data stores in order to perform the analysis required.
Compounding this challenge is that the analytics platforms in place in today’s HCOs focus largely if not entirely on clinical data when social, environmental, and behavioral factors comprise up to 90 percent of a patient’s determinants of health. Leading HCOs are only just beginning to incorporate these datasets into their analysis of patient/population health but will need to move aggressively forward to truly capture the complete determinants of health for their patients to guide care coordination and patient activation across the entire care delivery chain – from preventive services to diagnosis and treatment to ongoing self-care in the home.
In many cases, this process is easier said than done, as data resides in disparate clinical, claims, laboratory, pharma, public health and patient-generated systems. Integrating these data sources is complicated and costly, but doing so gives HCOs greater insight into the services that patients have already received and still need – which helps avoid the duplicate tests, unnecessary services, and readmissions that the VBC model punishes.
Chilmark Research Value Chain Model
The Chilmark Research Value Chain Model will help HCOs adopt a step-by-step process to identifying the stakeholders, processes, and outcomes that are key to a 360-degree analytics strategy in a VBC model. The Value Chain Model covers the analytics needs of HCO stakeholders – patients, clinicians, payers, finance departments, data informaticists and members of the extended care team – and the various VBC deliverables associated with analytics platforms today. In addition, the Value Chain Model captures some of the structural and behavioral changes necessary for an HCO to address hospital readmissions, utilization management, and other fundamental principles of VBC. As a result, the Value Chain Model can be applied to broad population health management (PHM) initiatives as well as individual patient care plans.
“With most survey’s revealing that only one in five HCOs having a data governance strategy, we feel that a value chain approach that begins with governance frameworks and maps analytics needs and use cases across the value chain will provide HCOs of all sizes an opportunity to realize a far greater ROI on data analytics offerings. Adopting a value chain model will also assist HCOs in successfully mapping analytic insights into workflows more effectively. Creating “data-driven organizations” is more than a matter of simply implementing technology,” said Jody Ranck, author of the report.