How payers can advance value -based care

Health care undergoes a major change. The increase in costs, an increasing number of cases of chronic diseases and an aging population revealed the limits of the traditional reference model (FFS). Under the FFS, providers are paid according to the volume of services rendered – unimportant of the results. This has led to ineffectiveness, fragmented care and increasing financial pressure on patients and payers.

On the other hand, Value -based care (VBC) The models prioritize the results on the output. Instead of rewarding the number of procedures, VBC encourages preventive care, improving patient results and coordinated treatment plans. This approach is gaining ground through the health care ecosystem as a more sustainable and effective means of providing care.

The crucial role of the payer in the progress of the care based on the value

Payers are only placed to carry out the costs to value -based care. Their role goes far beyond reimbursement; They can shape incentives, guide supplier behavior and ensure that good data and good tools are in place to support this transformation.

Here is how payers can generate an impact:

• Educate suppliers: Not all suppliers do not know VBC models. Payers can help fill the knowledge gap by offering training and resources that support coordination of care, monitoring of results and performance -based incentives.
• Strategically data sharing: Payers have access to complete data on complaints and information from the patient population. When shared responsible for suppliers, this data can help identify caregivers, improve patient engagement and generate better health results.
• Implementation technology: The transition to VBC requires tools for aggregating data, analysis and robust report. These technologies allow suppliers to be able to make informed decisions and help payers to assess the efficiency of their programs.

Why is technology essential

The backbone of value -based care is data– and the ability to act on it. Without integrated digital systems, it is difficult for suppliers to follow performance measures, manage high -risk populations or rationalize workflows.

Key technologies include:

How Veradigm supports payers in value -based care

Veradigme Offers a full set of solutions designed specifically to help payers succeed in value -based care environments. Their tools focus on improving interoperability, reducing friction and generation of usable information.

Veradigm products highlighted include:

• Veradigm network:: A secure and interoperable platform that links stakeholders through the health care ecosystem. It allows more efficient data sharing and supports better clinical and financial decision -making.
• Veradigm Echart Courier ™:: Simplifies and automates the recovery of medical graphics for quality measurement, risk adjustment and audit – saving time and reduction errors.
• Veradigm Pay analytics:: Provides real -time performance monitoring, KPI monitoring and predictive information that helps payers to proactively adjust the VBC strategies.
• Veradigm Pay insights:: Includes payers’ data directly into supplier electronic health files (DSE), issuing real -time alerts on care gaps and supporting better results when visiting patients.

Conclusion

For payers, value -based care is more than a reimbursement model – it is a more efficient, durable and centered health system. But success requires the right combination of data, collaboration and technology.

Veradigm solutions are specially designed to meet these needs, offering payers the tools not only to monitor and improve performance, but also empower suppliers and patients.