Value-based care models, social determinants of health on HIMSS19 docket

Trends to watch at HIMSS 2019

Patients increasingly want personalized care, which is driving healthcare providers to turn to value-based care models, a pay for performance model that rewards providers for quality care. Value-based care is one of the trends HIMSS predicts will gain ground in 2019, according to its recently released report, "2019 Healthcare Trends Forecast: The Beginning of a Consumer-Driven Reformation."

Terrence O'Malley

For O'Malley, who will participate in a panel about healthcare data exchange, he's keeping an eye on the economics of value-based care models.

"Payment models are changing dramatically," he said. "It's hard to underestimate the impact of moving from fee-for-service, which is our traditional payment model, to value-based payments, payments for outcomes. The difference is stark."

With a fee-for-service model, clinicians are paid based on the number of services provided. Value-based care models, on the other hand, reimburse clinicians based on patient outcomes. Insurers, the government and patients are demanding lower costs for services, as well as more transparency into how healthcare spending results in quality care. These demands are helping push the industry to adopt value-based care models, according to the HIMSS report.

As part of that shift, the healthcare industry is placing more emphasis on the social determinants of health, or the circumstances and conditions surrounding patients that can affect their health such as income level and education.

Karen DeSalvo

DeSalvo, professor of medicine and population health at the University of Texas at Austin Dell Medical School, expects that, as healthcare providers shift the way they treat patients, social determinant data will take on greater significance -- something she's hoping will become a trend in 2019.

"I think we've woken up as a country to the fact that health is more than healthcare," she said. "I think from a policy level and in the public and private sector, it's clear health is driven by more than just what happens in the healthcare setting. And so there need to be other sources of data informing everyone engaged about the person's health." 

DeSalvo, who will talk about how data-empowered patients are impacting healthcare, hopes healthcare players will find ways to meet the technical expectations needed to document and act on the social determinants of health this year. It won't be easy, she said, as they'll need to build tools, devices and approaches suited for a world focused on health instead of healthcare.

Digital health tech continues to advance

Along with value-based care and social determinants of health, the HIMSS report predicts that digital health technology use will continue to grow and become more widespread this year. But it also suggests that those technologies will need to demonstrate tangible results.

The HIMSS report said to expect continued and increased adoption of AI and machine learning tools for population health management, the routine use of virtual reality for pain control, greater use of voice assistants in the clinical setting, and use of wearables for remote patient monitoring. The uptick in usage may be significant. In its recently published global healthcare market forecast, Frost & Sullivan predicted that the use of digital health technologies to enable remote patient monitoring will increase by 30% in 2019.

I think we've woken up as a country to the fact that health is more than healthcare.

Digital health technologies can help patients now and in the future, according to O'Malley. Data generated by wearables, devices that enable healthcare providers to monitor patients in real time, can be analyzed for better preventive care. Approaches such as population health management, which aims to administer care across a group of patients, can provide better care in the short-term by integrating and analyzing clinical data to uncover new insights and expose care gaps.  

"A lot of the wearables, all of this data that's being generated by individuals now rather than by a healthcare system, where does that data go, how does it fit, how can we prevent things -- that's the long-term focus," O'Malley said. "The long-term vision is better health. The short-term vision is better management."

Government regulations, policies at HIMSS 2019

As HIMSS 2019 approaches, healthcare professionals continue to watch for a long-awaited rule on information blocking from the Office of the National Coordinator for Health IT and a new interoperability rule from the Centers for Medicare & Medicaid Services. The 35-day government shutdown impacted their release.

DeSalvo said it's important for the public and private sectors to continue to work together to create good policies when it comes to healthcare.

"We have a lot of near-term work we're making good progress on in partnership between the public and private sectors, like FHIR," DeSalvo said. "I think we need to keep pressing as quickly as possible on that work so we don't lose the momentum."