As technology's role in the health insurance industry grows, payers are moving on to their next IT challenge: measuring value, InformationWeek reported.
The industry shift to value-based care means payers need tools to measure value to keep providers from falling back to fee-based care, the article noted. Employers also need payers to rise to the challenge with calls for longitudinal data across home, work and wellness programs.
So health insurers are asking technology developers to create systems that capture, asses and analyze value. However, data infrastructure still falls short of those demands.
"There's a gap between the way we're implementing these technologies and the [goals]. That gap is becoming greater, not smaller," David Lansky, Ph.D., CEO and president of Pacific Business Group on Health, told InformationWeek. "To support the goals for society, to improve health and improve the healthcare system, we've got to support the innovative use of information technology and unfortunately, we're not doing that."
To measure the value of knee replacements, data should note whether patients walk better six months after their operation, Lansky said, but existing payment systems don't capture that information.
But technology could soon catch up with the shift to value-based care, thanks to the Centers for Medicare & Medicaid Services offering financial and technical support to help states implement new healthcare delivery and payment models. Part of the available funds will go toward data quality infrastructure to support care and payment, FierceHealthIT previously reported.
The need for systems that measure value comes as White House advisers urge insurers to speed up the adoption of value-based reimbursement so the entire healthcare industry can to improve efficiency, productivity and quality.
- read the InformationWeek article