Payers seek ways to attach value to data
ORLANDO – Everyone wants data, but the more elusive goal is getting value out of that data, according to John Walsh, chief technology officer for Horizon BCBS of New Jersey.
“Realizing the value of health IT, we’re seeing promising trends and actual results here, Walsh said.
Dave Bennett, executive vice president, product and strategy, for Orion Health, said he’s not the first person to say software is a drug.
“We think data is going to drive healthcare,” Bennett said. “Healthcare is going to be a math problem.”
To get to a longitudinal patient record, one which looks at the entire patient and record, systems need technology to handle and store data.
This is getting more important as healthcare moves to a world of consumerization. Digital therapies now can predict who is at risk for a heart attack by the sound of a patient’s voice, according to Bennett.
Horizon has been partnering with providers to aggregate data and analyze it, Walsh said.
There’s a focus on wellness metrics for their patient-centered pediatric program. There are no specific programs around childhood obesity, but measuring weight leads to conversations, Walsh said.
“Data plays a huge part in trying to understand what’s going on,” he said.
Another question, possibly for future attorneys, is who owns that data, the speakers said.
Horizon covers about 50 percent of the New Jersey market, an area with the highest premiums in the country, where the cost of care is skyrocketing, and there’s an out-of-network challenge being next door to Manhattan.
Walsh sees a lot of waste in the market. He believes 30 percent of spend is a waste.
Horizon began moving into value-based care in 2011 and currently has about 19 bundles across nine specialties. It has seen significant improvement through the ACOs, Walsh said.
The result is ER visits are down 5 percent, the total cost of care is down 9 percent, hospital admissions, 8 percent, and there are better controls for diabetes and screenings.
This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.
