UnitedHealthcare: Value-based care models must include infrastructure support to providers

A stethoscope and paper money.
A new study from UnitedHealthcare finds value-based care programs need to incorporate technical support. (Getty/utah778)

Value-based care models can’t be about just how to reduce spending or improve quality of care, according to a new study.

The study released Monday and conducted by two Harvard University researchers on behalf of UnitedHealthcare emphasizes the need for such models to incorporate infrastructure support such as technical assistance. The study is based on an examination of 24 value-based care programs from public and private payers.

The authors concluded that a value-based model must include three dimensions.

The first two dimensions focus on payment incentives to reward providers for reducing spending and improving quality. The third dimension relates to the types of infrastructure support the payer can give to the provider.

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Infrastructure support can vary from the payer offering reports on care spending, quality or other metrics to raw administrative or claims data. Technical assistance is another type of support that a payer can offer. 

“While the financial components of (value-based care) programs may provide some of the motivation that provider organizations need to change, infrastructure supports may be necessary to deliver the skills and experience that enable organizations to do so,” the study said.

To the researchers’ knowledge, few have “systematically characterized and tallied the types of infrastructure supports that are being deployed as part of (value-based care) programs.”

The study found that all but one of the 24 programs offer at least one type of technical support. The most common type of support offered to providers was analyzed data or reports.

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Another issue is the wide variety of quality measures providers must follow.

For instance, some evaluations would use anywhere from “six to over 20 different process measures to investigate changes in care quality,” the study said.

There is a cost and complexity to tracking and reporting on spending and quality measures that “is not insignificant in terms of time and financial resources for provider groups,” the study added. “Alignment of these measures across the range of payer contracts is required to deliver better value of care throughout the system.”

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The study makes several recommendations for value-based care programs, which include building a stronger relationship between the payer and provider so data and financial information can be shared.

“It appears that payers and providers benefit from data sharing, with payers providing more of the financial information and patient touchpoints throughout the healthcare system, and provider organizations providing more of the data on total population health,” the study found.