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For many years, healthcare providers have been paid under a “fee for service” model, that is, they are paid for each service and/or supply that they use to deliver care to a patient, regardless of the outcome or results received by the patient.   There has been a shift in this mindset and a drive to reduce spend by reimbursing providers based on an entire instance of care rather than pay for every individual service or item.  New payment models are being accompanied by incentive programs for providers.  The assumption is that these value-based models will decrease the cost of care and improve health of patients.

But these changes in care and payment require vast amounts of data – patient information and diagnoses, risk factors for different types of care, statistical analyses, results of various clinical protocols and identifying the best care options, etc.  

The road to value-based care is challenging given the many options and requirements, but the pressure to reduce cost and improve quality will not go away.   Payers and providers need information and analytical capabilities to perform successfully in this space.

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