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 1. Home
 2. HealthEdge Blog
 3. The Role of Technology in Advancing Value-Based Care


THE ROLE OF TECHNOLOGY IN ADVANCING VALUE-BASED CARE

Published Date June 29, 2023 Author HealthEdge


 * 
 * 
 * 
 * 

The Evolution of Value-Based Care

While the term “value-based care” has gained popularity, its widespread adoption
has been slower than anticipated. It essentially represents different
contracting models beyond traditional fee-for-service reimbursement that aim to
reduce costs and improve health outcomes.

The main challenge in expanding value-based care is getting both payers and
providers comfortable with the uncertainty of reimbursements under these
arrangements. Providers often struggle to shift from their fee-for-service
mindset and adapt their business operations to take on financial risk. Payers
are often unsure about how to best build and manage their care networks to
achieve their value-based care goals while also meeting the needs of the
populations they serve.

Building a partnership between payers and providers, based on transparency and
information symmetry, is crucial for successful value-based care implementation.

The Role of Technology in Value-Based Care

Complex workflows, analytics for identifying gaps in care, and member risk
stratification can be facilitated by modern care management systems. Digital
tools and mobile infrastructure can empower members to be more engaged in their
care, especially when they are outside of their traditional healthcare setting.

Technology can also help health plans tap into the vast amount of data they
possess to evaluate performance across various measures, such as HEDIS and STAR
ratings. It can also be used in predictive modeling for gaps-in-care analysis,
which can help identify members at risk before they experience an adverse event.

Many health plans face challenges in consolidating data, analyzing it
effectively, and presenting actionable insights from it. Modern technology
platforms are needed to support value-based contracting, enabling accurate
comparisons between providers on different payment models, and fostering
transparency in the provider-payer relationship.

HealthEdge’s Contribution to Value-Based Care Success

HealthEdge offers modern technology solutions that support payers’ efforts to
manage value-based care arrangements. HealthEdge products, such as HealthRules®
Payer, GuidingCare®, and Source streamline claims management, adjudicate
capitation arrangements, facilitate care management workflows, and improve
payment integrity. The company’s Wellframe® product enables digital care
management, enhancing patient engagement and improving health outcomes.
HealthEdge’s technologies aim to simplify healthcare processes, deliver
real-time information, and improve overall member experiences.

At HealthEdge, we believe value-based care holds the potential to transform
healthcare delivery and reduce costs. That’s why we are focused on helping the
healthcare industry make progress against their value-based care goals by
leveraging technology to provide real-time cost and benefit information to
members and providers, resulting in greater transparency and better healthcare
experiences.

To learn more about how HealthEdge solutions can help your better manage risk,
streamline operations, and enhance member experiences, and pursue value-based
care arrangements, visit www.healthedge.com.


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