Timely Issues Featured in American Hospital Association’s 2022 Environmental Scan Can Be Supported and Improved by the Advancement of Value-Based Care Models
The American Hospital Association (AHA) recently published its 2022 Environmental Scan, which focused on several timely issues impacting the healthcare industry. They included:
- The financial and operational challenges of the system
- Workforce shortages, resiliency and the future of work
- Health equity, including digital health access
- Care delivery transformation, including telehealth
Obviously, each of these areas has been specifically, and profoundly, shaped by the COVID-19 pandemic. The other key takeaway here is that all of these priorities can be positively addressed through the advancement of value-based care models. Let’s take a closer look at some of the AHA’s findings and how the transition to value-based care can prove valuable for providers moving forward.
Hospitals and health systems experienced unprecedented financial losses in 2021, after posting historic losses in 2020, according to AHA. It is estimated that providers lost $54 billion in net income this past year. These losses came from a combination of lower patient volumes for nonemergent care, added expenses from disruptions to supply chains and labor markets and the costs associated with caring for COVID-19 patients. The pandemic has largely signaled the beginning of the end for the fee-for-service payment structure that has long served as the industry’s primary funding model and has long been showing cracks in its foundation.
The AHA report highlighted that 85 percent of providers believe the pandemic has accelerated the need for healthcare delivery innovation. Once providers experience what’s possible with alternative funding models, they typically want more change, not less. The same body of research showed that 58 percent of providers already participating in at-risk or value-based programs plan to add value-based contracts within the next 12 months.
Providers who were already engaged in value-based care models were better sheltered from some of the most severe financial strain placed on healthcare organizations during the pandemic. That’s one reason why 26 percent of healthcare executives said value-based care as a leadership role was growing in importance within their organizations, a number which will continue to climb.
It’s a problem when 62 percent of front-line healthcare workers and 61 percent of physicians are reporting issues with stress, burnout and other mental health issues. Yet, that’s where we are currently as the pandemic drags along. The healthcare workforce has been stretched thin and has been over-burdened in a way that is no longer sustainable. In fact, providers will tell you, it wasn’t sustainable even before COVID-19.
We need to be considering ways to make structural changes that better support clinical personnel as they try to fulfill their mission of caring for people, both now and even after we finally exit the throughs of the pandemic. The tools and systems made available in a value-based care setting are part of the formula for addressing both worker shortages and burnout. We can better equip providers to manage their patients, including access to better data, better point of care decision support and more effective ways of administering a population health approach. We can help them ensure that high-risk individuals are appropriately escalated and intervened with, while lower risk patients are supported and empowered through education and digital support. We can create scenarios where providers more frequently operate at the top of their license, while having the information they need to make the best possible decision for each and every patient. If we do this in a way that is integrated into their clinical workflows, we can create a scenario where providers are actually delivering the kind of care they signed up for in the first place.
Historically marginalized groups are disproportionately feeling the consequences of COVID-19. While hospitals and health systems have “renewed their commitment to promote racial justice and health equity,” there is a lot of work left to do for us all. As an example, the AHA report cited a 9 percent increase in rates of severe maternal morbidity across all women in recent years. It was 63 percent higher in majority Black communities than in White communities and 32 percent higher in Hispanic communities compared to majority White communities.
In value-based care, we can actually weave health equity into the fabric of the care model. We can prioritize it by providing clinicians with tools that are culturally sensitive and responsive to racial, ethnic, geographic, socio-economic and environmental factors. We can incorporate equity outcomes into measurement and financial reimbursement so that improving health equity is an aligned imperative for all groups.
Nearly seven out of ten U.S. patients have seen a healthcare provider via telehealth since the pandemic began. Meanwhile, nearly half of Americans say they would be likely to switch, or have already switched, to a different provider if their current provider was not able to offer telehealth appointments.
Half of Americans are comfortable allowing information to be sent directly from a digital device to their doctor’s office, and they actually want this type of information collected by their doctor because of its usefulness in providing them quality care.
Creating digital pathways for patients and providers to work together makes sense for both sides. With the right mix of virtual and in-person care delivery, we can optimize outcomes, cost of care and patient experience. With the effective deployment of digital tools, we can keep patients and providers connected between visits for deeper relationships and more consistent education and support. Patients are ready to embrace health technologies. Providers are ready to lean more on digital tools.
Value-based care models create an environment where the use of digital health solutions is encouraged and rewarded instead of new echnologies being trapped behind artificial barriers to their adoption and use. With the right approach to value-based care, you can digitally activate both the patient and the provider and create patient-centric care for all. This will lead to healthier patients who are more satisfied with their healthcare interactions, and providers who feel more empowered and effective at delivering care.