The unavoidable shift toward value-based and two-sided risk payment models is here to stay – and while the benefits are countless, the journey thus far has been slow and somewhat painful for payers, providers and healthcare organizations alike. Healthcare is one of the slowest industries to effectively adopt technology and the reasons for this are clear. After all, healthcare is (and should be) a people business, not a technology field. However, the need for technology and the data that comes with it in the effective execution of shared risk programs can’t be argued.
Getting the most out of two-sided risk programs requires a continued, expert focus on risk adjustment. This comes with an in-depth evaluation and understanding of your data. While hospitals and healthcare providers certainly generate an incredible volume of data – particularly with the implementation of electronic health record (EHR) technology – understanding, evaluating and using the massive amounts of data has been (and remains) a real challenge for providers and healthcare organizations. According to a poll conducted by the National Association of ACOs and Leavitt Partners, eighty percent of ACOs are using a population health analytics solution in addition to their EHR applications.
But just having raw data isn’t enough – it has to be accessible, aggregated, analyzed and most importantly – the data has to be used to improve performance at every level. Payers that understand their data and can help healthcare providers become intimately familiar with their own data and what it means are most likely to be those who are effective in the transformation to lucrative risk-sharing programs. This means identifying and developing plans to manage high-cost members, among other key strategies such as enhancing quality scores, and improving the overall performance of the network.
But how can you gain mind-share and attention among a group of providers who are already inundated and overwhelmed with data, documentation and potential burnout? You have to make it easy for them – and that comes with the utilization of exceptional, yet simple-to-use technology.
GeBBS Healthcare Solutions’ iCode technology for risk adjustment delivers actionable data, real-time dynamic reporting and full transparency to support payers as well as a tool for identifying opportunities for provider education and feedback. Featuring a unique client-facing dashboard and provider education platform – GeBBS technology can help support this critical transition with decades of proven expertise. To learn more about GeBBS Payer Solutions and technology, please request a consultation.