Uptake of value-based care contracts has been relatively low, even if most healthcare provider organizations know that it represents the future. The reason is simple—uncertainty.

“Some providers don’t know where to start; people need help,” said Tamara StClaire, chief innovation officer of commercial healthcare at Xerox Healthcare, during HDM’s Most Powerful Women in Healthcare IT conference last week in Boston.

Terri Steinberg, MD
Terri Steinberg, MD

Not only is there much not known about value-based care, but the transition is difficult, said Terri Steinberg, MD, chief health information officer and vice president of population health informatics for Christiana Care Health System in Delaware, an accountable care pioneer. “The long and short of it is that it’s the hardest thing we’ve ever done.”

Healthcare organizations are risk-adverse, and the idea of changing payment models is scary, she added. Chief financial officers don’t like the risk involved in value-based payment. Nonetheless, an organization has to “aggressively pursue risk,” Steinberg said. “We have cannibalized our revenue stream, but are partnering with payers to come up with terms that keep both of us whole.”

Katherine Schneider, president and CEO at Delaware Valley ACO, said she does not see how a small provider can survive without being tied to another organization. The problem is that hospitals don’t want to employ all the doctors; they can’t afford it. Steinberg quickly agreed: “I spent 16 years in private practice and would not want to do it today; it’s simply impossible.”

While many health information exchanges across the nation have struggled, they remain important, as does the data that they hold because data exchange drives transformation, Schneider noted. The richest resource in Delaware for providers is the Delaware Health Information Network, which is among the most viable of HIEs, Steinberg said.

Still, the lack of quick access to current data continues to hurt providers, she said, adding that, “the notion of data transparency drives every part of value-based care."

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