Payers may find that the right assessment, analytic strategies and using quality measures to monitor success can help provide better service while reducing unnecessary expense and prove critical in implementing a value-based system, a recent Health Payer Intelligence article suggests.
According to author Thomas Beaton, employing a population health analytics strategy can help insurance companies identify the prevalent health risks and conditions within certain populations and implement health management strategies to combat those issues. Process and outcomes measures help payers determine if beneficiaries are receiving preventative care services as needed and if those activities are leading to health care improvements.
Payers should also look at the largest spending drivers within their organization before developing a value-based payment model, the article states. Identifying where high spending occurs will help an organization to design payment models appropriately. Models should be simple for providers to adopt, and health care providers must understand data and coding procedures.
“A health plan data governance strategy can help onboard providers into value-based agreements,” Beaton writes. “Health plan governance can help providers understand the datasets and coding processes needed to earn value-based reimbursement.”
Clearly defined payment models can lead to cost savings.