What does transitioning to value-based care look like? And how does digital health factor into this transformation?

In this episode of the Memora Health Care Delivery Podcast, we’re thrilled to speak with J.D. Whitlock, CIO at Dayton Children's Hospital, to explore these questions. Joining Dayton Children’s after working within the military healthcare system for the Air Force Research Lab, J.D.’s specialty is expanding accountable care and managing healthcare IT. 

Here’s a rundown of what we discussed.

Fee-for-service healthcare is fading, but value-based care is still challenging

With most healthcare organizations losing revenue, the traditional fee-for-service healthcare model clearly needs to change. As care and supply costs surge, providers are forced to do more with less, facing pressure to cut overhead while improving health outcomes and the patient experience.

That’s where structures like Accountable Care Organizations (ACOs) come into play. These are groups of doctors, hospitals, and other providers who join together to deliver coordinated care. The idea is to put the patient at the center of the care equation, getting them the care they need – when they need it. And, if ACOs show they can elevate healthcare delivery while cutting costs, participating providers receive better reimbursements from Medicare.

At Dayton Children’s Hospital, around 50% of its patients are in accountable care arrangements, increasing access to high-quality care and putting the patient first in its care model. 

But keeping value-based care sustainable doesn’t go without its challenges. J.D. says, “If you are successfully reducing acute care utilization and keeping patients healthier and out of the hospital and out of the emergency department. That's good for the patient, obviously. But in the ACOs that are health-system sponsored … you're not actually making money doing that. You're losing less money on the patients that are not coming to your hospital in your emergency department, right? And so that is a little bit difficult for the health systems, particularly in difficult financial times. It is challenging to do … even in a value-based care environment.”

That’s why it’s so important to pair the right technology that cuts down on operating costs while improving patient navigation.

Digital health supports accountable care organizations – but it needs to integrate

The health industry is buzzing with innovation focused on streamlining care delivery. But how easy is it to adopt and integrate these technologies? 

There's a lot of momentum around new tools that make the process of delivering care easier, like intelligent care enablement platforms — scalable technology that supports both patients and care teams through complex clinical episodes to more efficiently deliver personalized, proactive, and coordinated care. J.D. feels excited about the progress of digital interoperability with EHR apps. It used to be common to hire a company only to find out later that the amount of effort required for interfacing with and adopting the program was twice as big as the software’s cost. These stepbacks would increase implementation time by up to a year.

But EHRs like Epic are working to optimize their EHR app stores to help solve that issue for users and vendors. These digital markets have the potential to enable users to evaluate ease of integration and search for a particular functionality that organizations can adopt as seamlessly as possible. 

Digital healthcare needs to have ROI

Incorporating digital health solutions is a smart move – but the reality is that they need to make sense from an ROI perspective, even if that return is not necessarily reflected immediately in financial terms. 

J.D. explains, “There are a lot of great tools coming down the road, a lot of good venture capital investments. So I'm hopeful that in the next few years, we will see a lot of these things that will be easier to implement than they have been in the past. Now they still need to make economic sense. Sometimes vendors ask for prices for things that just don't make sense from an accountable-care perspective. So it still needs to make sense from an ROI perspective, but I am hopeful that a lot of these tools are going to be commercializable and implementable where in the past they have not been.” 

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