Healthcare organizations invest in system integration and health information exchanges to get the data required by value-based purchasing, which holds providers accountable for the cost and quality of care.

Nicole Lewis, Contributor

June 12, 2012

4 Min Read

8 Health Information Exchanges Lead The Way

8 Health Information Exchanges Lead The Way


8 Health Information Exchanges Lead The Way (click image for larger for slideshow)

Value-based purchasing (VBP), in which buyers of healthcare services hold providers of healthcare accountable for both the cost and quality of care, is driving provider organizations to seek the IT tools required to make this model work. When asked about their top IT spending priorities to advance VBP objectives over the next three years, 49% of 204 senior executives surveyed said they will invest in system integration across all applications and 47% said they'll spend on health information exchange (HIX) networks.

The Forbes Insights report--Getting From Volume to Value in Health Care: Balancing Challenges & Opportunities--also found that speeding the shift to a VBP model makes sense, with 73% of the C-suite executives surveyed saying they either "completely" or "somewhat" agreed that providers must immediately begin shifting their focus from volume to value.

The VBP purchasing model is becoming extremely attractive as the shift toward greater accountability of care and pay for performance in the healthcare industry grows. But to achieve VBP goals, the healthcare system must rely on a data-driven environment that provides information on quality measures such as patient outcomes and health status, as well as financial data on the cost of care. In the VBP approach to care, organizations buying healthcare services place the onus on providers to wring costs out of the system. This approach also helps to identify and reward best-performing providers.

As health delivery organizations look for the best ways to implement a VBP model, C-suite executives at hospitals are trying to figure out what data will be crucial. At a press briefing June 5 to discuss the report's findings, Michael Millenson, president of Health Quality Advisors and the author of the report, said healthcare delivery organizations are demanding data. He also said the shift to VBP will set the stage for improvements in care collaboration between patients and their doctors.

[ Practice management software keeps the medical office running smoothly. For a closer look at KLAS' top-ranked systems, see 10 Top Medical Practice Management Software Systems. ]

"C-level executives are asking 'what is the data I need that is the lifeblood of management that my predecessors never had, but that is going to become routine in the future?'" Millenson said. "You have an [electronic medical record], what are you doing with it? That's the question of the future? Are you having a meaningful relationship with your EMR? The government wants to know."

The poll also revealed the critical role played by health IT in both financial and clinical preparedness. C-suite executives said the most important uses of health IT are: identifying patients who generate high costs within the hospital (66%) and in the ambulatory environment (56%); ensuring that nurses and doctors have evidence-based protocols (61%); and getting complete and current information across the care continuum (58%).

In the meantime, 63% of those surveyed said they're already participating in a Medicare accountable care organization (ACO) or expect to do so eventually. The majority of survey respondents also said they have been approached by private payers and/or state and local payers regarding VBP.

The Forbes Insights' poll found that about two-thirds of surveyed executives believe that consumer financial incentives--for example a high-deductible health plan with health savings accounts that allow employees to retain money they don't spend--are keys to making VBP successful (64%). However, about the same percentage (67%) also thought that consumers won't know when that success arrives, since they can't accurately judge the value of medical care. Analysts at Forbes Insights say that's a warning to those who believe that the high-deductible health insurance arrangements known as consumer-driven health plans will automatically drive value-based purchasing on the part of the patient.

Another warning cited in the survey: half of the C-suite executives said that the top barrier to VBP participation was full engagement by their doctors.

"We are committed to helping our clients through this change, which is why we sponsored this survey," Glen Tullman, CEO of Allscripts Healthcare Solutions, said in a statement. "The results make it clear that the industry sees some hurdles to making value-based purchasing work. We're continuing to develop tools and solutions to help our clients make the shift successfully."

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