It’s clear that the value-based care payment model effectively reduces the cost of health care. In fact, research shows that its implementation could achieve savings of nine to 16% on a provider’s total budget in chronic disease management alone. 

However, financial professionals such as yourself must monitor relevant metrics to align quality and cost of care. Data analytics supports both equitable care and long-term financial success, making it vital to implement analytics in your approach to value-based care.

Without the right approach, navigating the vast amounts of data collected in the healthcare industry can be inefficient. Equipped with a healthcare dashboard and a list of financial metrics to track, professionals across the care continuum can deliver cost-effective value-based care. 

1. Patient satisfaction

Patient satisfaction indicates the degree to which a patient is content with the care received. This encompasses the quality of care provided, the care team’s responsiveness, and many other factors.

You can measure patient satisfaction by conducting regular surveys that inquire about the patient’s experience as a whole, from scheduling the appointment to receiving care and completing any follow-up actions. For example, ask patients to rate their experience on a scale of 1 to 5 with:

• The appointment scheduling process
• Their interactions with the provider and staff
• Their wait time
• The care they received

As patients submit their responses, categorize scores as “positive” or “negative.” For example, a low score might represent a poor or negative rating while a high score might represent a positive experience. 

Then, analyze survey results by dividing the number of positive responses by the number of total responses and multiplying the answer by 100 to get a patient satisfaction score. Higher patient satisfaction scores lead to increased reimbursement rates, while lower scores can result in financial penalties.

2. Readmissions

An organization’s readmission rate is the percentage of patients who return to a hospital within a specific timeframe (typically 30 days) after being discharged. You can calculate this rate by dividing the number of readmitted patients by the total number of patients discharged during the same period. Then, multiply the result by 100 to get a percentage.

High readmission rates hold significant financial implications, including penalties and negative effects on a hospital’s reputation. Notably, high readmission also leads to increased costs for providers and payers since every readmission requires additional resources, such as tests and treatments. 

According to Arcadia, providers can prevent readmissions using predictive analytics to identify patients at risk of readmission and proactively address their follow-up needs with personalized discharge protocols. For example, a patient’s history of chronic conditions or medication non-adherence might influence their risk of readmission. 

3. Patient access to care

Patient access to care refers to an individual’s ability to obtain necessary services in a timely and convenient manner. By addressing access challenges, providers deliver timely interventions and preventive services that reduce the need for unnecessary and costly care. 

You can measure access to care through several metrics, including:

• Practice capacity utilization, or the number of actual appointments scheduled compared to your practice’s capacity for appointments
• Appointment wait times, or the amount of time a patient has to wait before seeing their provider
• Geographic coverage, or the distribution of healthcare facilities relative to the population to highlight potential medical deserts

Depending on these metrics, providers can improve access to care in numerous ways. For example, a practice where patients have limited geographic coverage could establish a satellite clinic or mobile unit to bring health services to underserved regions.

4. Patient leakage

Patient leakage happens when a patient seeks care outside of their primary healthcare network. For example, imagine Jane underwent an inpatient procedure at one hospital, but decided to seek post-discharge care at another. This leads to lost revenue for the first organization and reduced market share overall, as patient leakage negatively impacts a provider’s reputation. 

To maintain continuity of care, evaluate the services that patients seek elsewhere and measure how often this occurs. Use electronic health records (EHRs) and clinical data to track patient referrals and follow-up appointments and identify patterns of gaps in care.

5. Total cost of care

The total cost of care represents the total cost of delivering health services to an individual over a specific period. This metric enables providers to identify at-risk populations and properly manage the cost of improving patient outcomes. 

Some of the costs encompassed by the total cost of care include:

• Primary care costs, such as the cost of consultations, treatments, and follow-up visits
• Emergency department (ED) costs, or the expenses associated with emergency care
• Procedural costs, including surgeries, imaging studies, and lab tests
• Post-care costs, such as rehabilitation or home health services

Tracking these costs is vital to initiate effective interventions. Invest in value-based care software to derive data-driven insights about these expenses and precisely allocate resources. 

Written By Lisa Carter