3 reasons providers should get active

The move toward value-based care means providers must be much more involved in pursuing improved outcomes
By Jeff Rowe
10:39 AM
doctor and patients

Remember when doctors made house calls? It's probably safe not to expect the return of those days any time soon, but some healthcare stakeholders are saying the time has come for providers to take a more active role in their patients' healthcare.

Better yet, some say, it's time for providers to band together and provide their patients with care that is both active and well-coordinated.

Mark Stabile is CEO of a New Jersey-based company whose mission is to use the latest technology to enable providers to coordinate care across the care continuum. Dubbed TEAM of Care – TEAM being an acronym for "Tech Enabled Active Management" – the company develops and maintains coordinated workplans for providers and patients.

As Stabile sees it, the move toward "fee for value" healthcare means providers have to be much more involved in pursuing improved care outcomes, which means they have to do a much better job of managing all components of a patient's care.

"The team component has not traditionally been part of US healthcare," he said, "and that's due to the reimbursement models" that paid providers for services rendered, but not necessarily for how, or whether, those services succeeded in helping the patient.

In assessing the healthcare sector, Stabile sees three trends pushing providers toward active care:

  1. A growing tension between uncoordinated care and new reimbursement models. ACOs, bundled payments and the move toward greater clinical integration require a number of things if they're going to succeed, but perhaps first and foremost is improved coordination of care.
  2. An increased focus on treating chronic disease. The numbers are impressive: According to AHRQ, 5 percent of the population accounts for 50 percent of healthcare spending, largely due to the money spent on chronic care. But, according to Stabile, "There's not a huge argument among providers about what things you can do for a diabetic," one of the more widespread chronic diseases. "Where you have a gap is in doctors knowing whether those things actually get done."
  3. Fee-for-value initiatives. Finally, on an operational level, providers need to do a better job of managing their clinical operations, as well as of measuring their effectiveness, in part so that they can have the necessary data available to participate in various government incentive programs.

In either clinical or financial terms, the problem facing many providers is not a lack of data, but a lack of coordination of that data.

As Stabile puts it, "You have the data, but data isn't enough. It needs to be connected to the workflow."

For patients, building a seamless connection between data and care means better health outcomes, while for providers it means getting paid for a job well done.

[See also: Value-based payment models expected to reach tipping point by 2018, study finds]

Doctor and patients photo from Shutterstock.com.