HealthEC Blog Posts

The Hare, the Tortoise and Transitioning to Value-Based Care Models

As health care providers adjust to payment reform, MIPS reporting deadlines and electronic record keeping, it sometimes feels like the industry is in a race against time. But as we all know, today’s health care information systems weren’t built for speed or agility.

And adjusting to new health care applications are one thing. Altering complex data management techniques and core philosophies about the delivery of patient care are another. But these transformations are not insurmountable challenges.

For some insight on how to approach the ongoing changes in the health care system, such as adapting to value-based care models, one needs to look no further than Aesop’s Fables. More specifically, the lesson from the Hare and the Tortoise – slow and steady wins the race.

Providers who rush to implement new value-based care delivery mechanisms, from either aggressive practice targets or their own “can do” spirit, are vulnerable to higher levels of frustration and burnout, and jeopardize the successful implementation of these programs.

This, of course, is not a recommendation to follow the lead of the hare and pull to the side of the road and rest. Rather, it is a nod to the tortoise, whose slow and steady approach eventually helped him come out on top.

Organizations that adapt to value-based health care delivery in stages are in turn, better positioned to thrive. Using simple guidelines that we will detail in future posts, transforming from fee-for-service to value-based strategies in an organized, deliberate manner, starts with data.

Data is the catalyst to credibility in driving long term change, compelling providers to evolve carefully and incrementally. Accurate data validates or nullifies assumptions about quality and performance, and can be used to establish goals and benchmarks. Reshaping physicians’ perceptions is predicated on sharing data to tell aggregate stories of needless spending, care gaps, quality metrics and utilization of facilities — all contributors to generating extraneous costs for uncertain value.

For physicians transitioning to value-based care models, there is a period of self-learning, self-evaluation and self-realization as they analyze information in new ways and appraise care across the entire patient experience based upon health outcomes. Successful models that are implemented over time will help physician achieve three specific goals:

  • Have visibility into their specific patient care patterns and resource utilization trends
  • Understand the overall health of the network’s patient population and identify high-risk, high-cost members and associated care gaps
  • Make more informed, evidenced-based decisions for each identified patient’s care

Unlike the hare, who couldn’t recover from his mistake, providers should aspire to be like the tortoise. And by transitioning to value models in stages, where data can provide compelling short- and long-term visibility, providers are likely to win the race toward value-based care.

Dr. Sanjay Seth

Blogger Name: Sanjay Seth

Date of Publishing : February 5, 2018

About the Author : Sanjay Seth, MD, is executive vice president at HealthEC. With over 30 years of clinical, administrative and consulting experience, Dr. Seth is uniquely positioned to develop population health management strategies that support health care providers and organizations.