Over the past decade, health care providers and insurance plans have increasingly pursued value-based care models that are designed to improve patient and clinician experiences while reducing costs and improving quality to produce better population health. With more community and consumer engagement, these models have huge potential for advancing key consumer priorities, including affordability, effective care coordination and communication, data sharing, and providing whole-person care. However, progress has been relatively slow, and the opportunity to engage patients in their care has not yet been fully realized. As value-based care models continue to improve and evolve, the definition of “value” for consumers and patients must also be broadened to include reducing inequities in access and quality.

In theory, electronic health records (EHRs) have the potential to transform the healthcare landscape. They were expected to provide a digital hub that would enable seamless communication and information sharing between providers, boost efficiency, improve the quality of care, and foster optimal patient and clinician experiences.

The reality, unfortunately, has not matched the possibilities. While well-intentioned, the Federal Government’s 2011 Meaningful Use Mandate program—to incentivize physician practices to adopt EHRs—did not specify detailed standards for EHR systems. The result was a fragmented landscape of multiple vendors offering poorly designed EHRs that met the certification requirements at the expense of the provider and patient experience.

Medicaid Value-Based Payment Reform Linked to Reduced Mental Health ER Visits

Behavioral Health Business | September 29, 2023

State Medicaid programs are increasingly overhauling payment structures in favor of value-based payment systems. A new report suggests that value-based payment reform may decrease mental health emergency room visits. Value-based payment strategies reward providers and health plans with incentive payments for the quality, rather than quantity, of care provided to patients. A new study published in the JAMA Health Forum found that Medicaid value-based payment reform was associated with increased behavioral health visits.

CMMI was created by the Affordable Care Act in 2010, with the goal of promoting value-based care and building pilot programs that would test new approaches in Medicare, Medicaid and the Children’s Health Insurance Program. Between 2011 and 2020, the center launched nearly 50 models, though only six generated statistically significant savings and four were certified for expansion, according to the CBO report. The CMS has estimated that more than 41.5 million people have been impacted by or received care in innovation center models since late 2020. Though the report concluded the center had increased net federal spending during its first years in operation, the agency noted its estimates of the financial impact of CMMI includes some uncertainty, some of which could inflate the increase in federal spending.

DataLink provides flexible data-driven solutions that help value-based care providers, payers, and organizations improve quality performance, optimize risk accuracy, and reduce costs. With intelligent insights, automated workflows, and advanced interoperability technology, DataLink simplifies value-based care so that providers can focus on what matters most: delivering the best health outcomes. Data-Link is widely recognized for setting industry standards with best-in-class, scalable data-driven solutions that simplify value-based care. 

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