Efficient Data Sharing Needed for Value-Based Care Transition

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Efficient Data Sharing Needed for Value-Based Care Transition

Data for the value

In this Rev Cycle Intelligence article, you'll learn about:
  • The struggle for providers in a VBC model

" Providers must have timely access to data to understand if they are within budget and, if they are not, what is putting them over budget. Providers also need feedback from payers to understand their progress toward meeting quality measures. "

  • How HIPAA makes things difficult for VBC models

" “Under HIPAA, you can only share data for treatment, payment, and operations, and it has to be specifically on a need-to-know use-case basis,” Rowe explained.

“So, for a payer to contract with a provider around value-based care, it actually means they have to change their data use agreement to make sure that all the data they need to get from the provider to help them will come in their direction and vice versa,” she added. "

  • Why data sharing is needed for VBC to succeed

" “If the provider organization now says, ‘Oh, well, I’ll share with you clinical information, and you can integrate that clinical information with your claims information,’ they now actually have more insight into what’s happening and whether the goals of those quality measures are being met, whether the encounters are ticking in at the right level, and they can provide that feedback in a more timely manner,” Rowe explained. "

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