The healthcare industry is in the midst of a major transformation to value-based care. In a 2017 Chilmark Research report found the number of accountable care organizations (ACOs) has grown 13-15 percent in each of the last two years and there are now more than 935 ACOs covering approximately 10 percent of Americans.
Early results indicate value-based care is working as intended to improve the quality and costs of healthcare. Some of the many examples are:
- Blue Cross Blue Shield of Illinois participates in 20 value-based arrangements that serve one in four of its members. The company reports emergency visits are down by 16 percent, hospital admissions have decreased 15 percent, and spending has declined by $17 per member per month.
- Harrisburg-based Capital BlueCross created its first value-based care contract in 2011, and now more than 2,800 physicians and 362,000 customers participate. Earlier this year, the company published results showing these value-based partnerships outperformed their fee-for-service peers in 19 of 25 tracked Healthcare Effectiveness Data and Information Set (HEDIS®) measures such as breast, cervical and colorectal cancer screenings and reduced emergency visits and hospitalizations.
- Anthem reports a 7.8 percent reduction in acute patient admissions, a 9.6 percent improvement on pediatric preventive care, and a monthly savings of $9.51 per participating patient.
At the heart of these success stories are advanced analytics platforms that integrate claims, clinical, lab, pharmacy and wearables data and apply predictive analytics to create one comprehensive profile of each patient. Join Mark A. Caron, as he discusses real-world examples of how health plans, physicians and others are leveraging advanced analytics to fuel the transition to value.