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The State of Value-Based Care and the Triple Aim


How far along are healthcare organizations in their pursuit of value-based care and the Triple Aim?

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There is no doubt that healthcare is moving toward value-based care, but just how far has it come?

A new report from Proskauer, an international law firm, seeks to answer that question. The report, “Checking Up on the Quest for the Triple Aim” surveyed 100 healthcare executives about their progress on the Triple Aim- reducing costs, improving the patient experience, and improving the health of populations-as they move from fee-for-service to value-based care models. From thoughts on M&A to insights on providing outcomes, the report focuses on the top concerns of healthcare executives.

“As the healthcare industry continues to evolve and new players enter the space, it is imperative for healthcare executives to understand where they are thriving, where they are falling short and have a clear path for the year ahead,” says Rick Zall, partner and chair of Health Care at Proskauer.

“In the near decade since the passage of the ACA,” Zall adds, “there has been much debate about its impact. While there are no simple answers, there is broad agreement that the Affordable Care Act initiated a new journey for most healthcare organizations-moving them from a volume to value-based model.”

The first major finding of the report is that healthcare organizations are primarily focusing on tech-related deals to boost existing services and capabilities. The report says this shows that “healthcare organizations are going back to the basics when it comes to M&A.” Of those organizations that had a target in mind, 31% said acquiring a tech company for AI capabilities was their main M&A target over the next two years.

Related: The Missing Link In Value-Based Care

As far as patient experience and services using healthcare data goes, while healthcare is improving, more work is needed: 44% of respondents said they need to improve employee training in technology use, 37% said they were prioritizing incentivizing participation in existing information sharing groups, and 36% said they were incentivizing vendors to encourage interoperability.  

When asked about business challenges, many executives (32%) said they worried most about cutting operating costs, as well as privacy and data protection.

“With the exception of GDPR compliance,” Zall says, “no more than a third of healthcare organizations currently leverage any singe cybersecurity best practice, such as implementing an accident response plan or using data encryption. Improving cybersecurity practices organization wide will need to be a critical focus in the year ahead.”

Another large takeaway from the report is that healthcare organizations and regulators are seeing more eye-to-eye in terms of improving outcomes. Over half of those surveyed gave CMS a score of 8 (on a scale of 1 to 10, 10 being highly effective) in terms of how effective they are at creating innovation. The average score for CMS was 6.49 (compared to 5.94 for state health departments and 7.01 for the FDA). When asked about their most pressing business challenge in the year ahead, just 15% of respondents cited regulations.

Nicholas Hamm is an editor with Managed Healthcare Executive

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