Value-Based Care Essay

The ability to integrate and analyze large and disparate sources of data for new insights into who, what, and how to manage the health of both individuals and populations requires advanced analytics techniques. Three examples of these advanced analytics concepts are predictive modeling and prescriptive analytics, and operations research.

Predictive modeling uses data mining and statistical techniques to identify unique groupings and to predict outcomes for that group. An example would be analyzing a data set made up of demographics (age, gender, weight) clinical data (blood pressure, blood sugar), health behaviors (smoking, diet, sleep) and social determinants (income level, education) to try to identify individuals that were at risk for developing health

A FedRAMP certified government cloud environment would allow an alternative data transfer method from FTP or mailing of hard drives, etc.

Spend management

Troop readiness is a primary focus of the quadruple aim and lower cost is a key component. Improved health status is tied directly both readiness and lower – or at least better managed - spending on healthcare services. The primary vehicle to managing spending is through managing medical cost trends and the implementation of value based care (VBC).

Value-based care is defined by the New England Journal of Medicine as:

Value-based healthcare is a healthcare delivery model in which providers, including hospitals and physicians, are paid based on patient health outcomes. Under value-based care agreements, providers are rewarded for helping patients improve their health, reduce the effects and incidence of chronic disease, and live healthier lives in an evidence-based way.

There are tremendous benefits to VBC including supporting:

• Improved outcomes and health status

• Reduced spending on healthcare