AHIP, the American Medical Association and the National Association of ACOs have teamed up to release a playbook that aims to arm stakeholders with best practices for value-based care.
The playbook is intended to help insurers, physicians, hospitals and other value-based care entities with best practices to design and implement future value-based arrangements. It focuses on creating a data ecosystem, sharing comprehensive data, improving data collection to advance health equity, sharing timely and accurate data and making all findings readily available.
“How do we scale value-based care and payment arrangements?” Danielle Lloyd, senior vice president of private market innovations and quality initiatives at AHIP during a webinar on Tuesday. “This playbook from our expectations is that it’s essentially a cheat sheet to advance participation more quickly and make it more effective at improving quality, equity of care, affordability of care and patient experience.”
“It is our hope that this unprecedented cross-industry effort can translate into tangible, industry-leading practices informed by real-world experiences that our nation's healthcare leaders can directly apply to build our own success,” said Carol Vargo, vice president of physician practice sustainability for the AMA.
The three national associations said they plan to build participation in value-based care arrangements, first focused on data sharing. The groups created an advisory workgroup, established a managing committee, completed literature reviews and conducted interviews with experts. Group members include national and regional health plans, large and small physician practices, and accountable care organizations (ACOs).
“This is not a product produced in the ivory tower,” said AMA President Jesse M. Ehrenfeld, M.D., in a statement. “Working together, they came up with a plan to improve patient care going forward. That teamwork, often seen in the clinical setting, proved invaluable in this setting as well.”
All three organizations came together after witnessing the challenges facing the U.S. care delivery system during COVID-19, including data accessibility, disparities in care and unintended payment incentives.
“We really all saw during the pandemic that the lack of integration between public health data, clinical data and administrative data was something that got in the way of our collective work,” said Lloyd. She noted that health insurance providers did not always have access as to who is insured if they didn’t receive a claim, making it more difficult for AHIP members to get vaccinated.
Vargo added that practices have felt depleted after the pandemic, leading them toward acquisition. Many of these corporations are not interested or able to participate in value-based care.
The report noted that value-based care groups run into data concerns like data privacy, standardization, varying infrastructure, participant acceptance to utilizing data, the financial investment required and Federal Health Information Technology standards that must be met.
Another playbook focused on payment methodology will be released at a future date, said Aisha Pittman, senior vice president of government affairs at NAACOS.