by Lynda Rowe
Globally, populations are aging and the prevalence of chronic conditions is increasing. At the same time, those paying for care struggle to support its rising costs. It’s an unsustainable situation, yet health systems must remain sustainable to meet the needs of entire populations. To achieve this, health systems are shifting to value-based and outcomes-based payment models, versus paying for the volume of healthcare services delivered. The new payment models focus on keeping patients out of the hospital through preventative screenings, wellness plans, at-home care, and other measures that can improve outcomes and generate shared savings. Medical technology (MedTech) companies can play a key role in the success of value-based care initiatives.
Many healthcare organizations have started to share risk with their payers. We tend to think of those taking on risk as hospitals, independent physicians, and even post-acute care facilities. However, forward leaning MedTech companies have started to think about their role in value-based care. For example, payers such as the Centers for Medicare and Medicaid Services (CMS) have left it up to the health systems implementing bundled payments to define how they will achieve value. That could include contracting with MedTech companies who agree to deliver better outcomes for the same or lower cost.
Many MedTech companies have found ways to participate in value-based care, such as:
- Demonstrating that their device provides effective and efficient care. For example, does use of your medical device make a procedure more efficient with fewer complications?
- Improving outcomes and experience for the patient:
- Use of in-home blood glucose monitoring systems vs. patient blood sticks, to help diabetics keep their blood sugar level in check.
- Consumer engagement tools to provide feedback on the effectiveness of a particular in-home monitoring device.
Those same MedTech companies have already entered into arrangements with payers and providers who will pay them for products and services contingent upon patient outcomes. Devices that bring clinical benefits to the patient and economic rewards to the system have become more attractive to organizations entering into value-based care models. According to a study published in Medtech Strategist, many progressive health systems seek partnerships with their MedTech vendors for help in value-based programs.1
The Value of a MedTech Data Strategy
To stay nimble and participate in value-based payment, MedTech companies need a data strategy that will bring value to providers, payers, and ultimately patients. This includes implementing technology to aggregate patient-centered data — including clinical, administrative, device, and self-generated — that can be the foundation for measuring the value provided by MedTech devices and services. MedTech solutions also can process aggregated data to deliver real-time feedback to patients and providers, and to establish their unique value.
The MedTech Advantage
The ability to collect patient-generated data gives MedTech a unique advantage. Over time, a longitudinal record can be used to analyze trends about device performance, patient specific responses to interventions, and provide feedback to patients. Allowing multiple participants — patient, provider, and device manufacturer — to receive alerts from devices in real time, such as when a blood glucose level goes out of range, can allow for more rapid interventions. Other benefits of a successful data strategy for MedTech companies include:
- Agility navigating the regulatory landscape. As federal regulators change and modify their programs, having access to a large clinical data set provides insight into the potential impact to your lines of business.
- Operational efficiency in controlling the costs of delivery in the traditional supply chain for value-based care, and in the MedTech as a Service approach where devices collect the data but the analysis and results define the service.
- Strength in negotiations using large data sets to really understand contracting options. Before negotiating contracts, MedTech companies can gain insight into value from historical performance and outcome data.
- Owning the therapy. An event-driven infrastructure, which aggregates, stores, and analyzes a longitudinal record, including device and therapy data, enables MedTech companies to intervene with patients in real time. Without the same access to the data and analytics, competitors cannot offer the same level of service or benefit.
Learn more about how InterSystems can become a central part of your strategy to participate in the global value-based care market.
Lynda Rowe is Senior Advisor, Value-Based Systems, for InterSystems. She provides guidance on alternative payment models, public sector,
state Medicaid programs, and related areas. She has over 25 years of experience in information technology, mostly in healthcare technology consulting and operations.
Follow her on Twitter @Lynda_Rowe.
1 - Medtech Strategist, June 27, 2018, Vol 5, No 9. Good News, Bad News, Hospitals want to Partner. Jonas Funk, Monish Rajpal, and Ilya Trakhtenberg, LEK Consulting.