Epic CEO Judy Faulkner

Value-Based Care

Measure What Matters… To Patients

Despite years of provider attention focused on getting out in front of consumerism, health system performance metrics remain centered on transactions rather than the strength of patient relationships. 

Kaufman Hall’s 2023 State of the Healthcare Consumer Report explores the key findings distilled from a survey of 59 healthcare executives, each revolving around quantifying consumer relationships and incorporating that data into operations.

The use of consumer-focused measurement remains limited among health system leaders, and organizations over-rely on traditional transaction-focused metrics.

• An FFS model that incentivizes volume gives rise to performance metrics that track the same, such as visit volume (tracked by 100%), market share (89%), and revenue per visit (86%).

• Only half of respondents track at least one advanced consumer-focused measure, such as share of a patient’s total healthcare spend, their lifetime value to the system, or churn.

While traditional metrics provide valuable insights, they don’t capture the “stickiness” of patient relationships, a key driver of both better outcomes and business improvements.

• One exec noted that most health systems deliver a wide range of services, but they rarely package and articulate them to consumers in a way that provides more touch points along the care continuum.

• By contrast, financial-service companies lean in on consumer-facing metrics, which allows them to go after share of wallet and lifetime value through integrated solutions.

Kaufman Hall then offers a Glide Path to Success for health systems looking to recalibrate toward a more relationship-based strategy.

• Perform an assessment of each service line using consumer-centric metrics
• Identify loyalty drivers by analyzing how patient choices impact upstream utilization
• Identify services that could be improved or added to improve consumer metrics
• Measure ROI to determine whether changes are creating the expected return and pivot if they’re not

The Takeaway

If the industry intends to shift from volume to value, it’s important to continue asking what exactly it is that patients value in their healthcare. Asking them directly is an obvious option, but consumers vote every day with their wallets and their business, so tracking that data seems like a critical first step to delivering on what really matters.

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The Wire

• Withings Body Pro 2 Launch: Withings Health Solutions just launched a major leap forward for its smart scale lineup with the Body Pro 2, which goes well beyond weight management with new engagement features and chronic condition management modules. Most importantly for remote care teams, the first Body Pro 2 module can help detect early signs of diabetes, specifically Diabetic Peripheral Neuropathies, and assess the risk for diabetic foot ulcers that have typically required an office visit to diagnose.

• Kythera Series A: Kythera Labs landed $20M in Series A funding to fuel the growth of its Wayfinder data platform and expand existing partnerships with players such as Datavant and Databricks. Wayfinder provides access to real-world healthcare data spanning over 8 years and 320M lives, supporting scalability with a “dynamically improving common data model that facilitates data integration.” We don’t have the space to decipher that here but it seems to be resonating, with Kythera pacing 41% growth and a 245%+ platform utilization increase in 2023.

• Cadence Delivers Strong CV Results: New research in Circulation demonstrated some impressive results for Cadence’s RPM solution, including a 2x increase in patients achieving goal blood pressure and a 50% reduction in total cost of care. Among 4,006 hypertension patients with a mean follow-up of 136 days, Cadence achieved a total reduction in systolic and diastolic BP of 9 and 6 mm Hg, respectively. The program includes a combination of RPM devices (connected BP cuff, HR monitor, and scale) and a multidisciplinary clinical team that monitors vitals and implements interventions to patients at home.

• Food is Medicine: The concept of “food is medicine” picked up steam on Monday after the Bipartisan Policy Center released policy recommendations in support of prescribing medically tailored meals to address chronic diseases like diabetes and heart disease. The recommendations include calls for Congress to boost Medicare coverage for specialized nutrition therapy, CMS to bolster data collection efforts for food-based reimbursement testing, and the creation of new medschool accreditation groups establishing “nutrition-specific competencies.”

• One Medical Partnership Tic-Tac-Toe: It’s getting hard to doubt the seriousness of Amazon’s healthcare ambitions after One Medical hit a tic-tac-toe of three new partnerships on top of last week’s Prime headline. The first partnership will see Hackensack Meridian offer New Jersey residents tech-enabled primary care via One Medical’s network. The second will give One Medical’s Seattle members access to specialty care from CommonSpirit Health’s Virginia Mason Franciscan Health. The third with Health Transformation Alliance will expand One Medical’s services to over 67 employers.

• Electronic Health Information Disparities: Another study diving into the Health Information National Trends Survey found that overall patient portal access improved each year since 2014. However, the latest data show that Black and Hispanic individuals were offered access to a portal by their HCP significantly less often White individuals (Black 73%; Hispanic 62%, White 81%). The study also showed that there were no differences in use or understanding of online medical records among those who accessed them, suggesting that efforts to promote equitable availability would directly translate to improved patient access.

• CareAbout + Innovaccer: Innovaccer is adding to its partnership hot streak with healthcare management services company CareAbout, which helps 1,500+ providers enable value-based care and accelerate practice growth. CareAbout will be leveraging Innovaccer’s data platform, population health solutions, and analytics to help its providers unify a “myriad” of disparate EHRs to gain actionable insights into quality, performance, cost metrics.

• Lung Cancer Survival Rises: In good news for the battle against lung cancer, an American Lung Association report found that the US five-year lung cancer survival rate rose from 22% to 27% between 2015 and 2019. When diagnosed early, the five-year lung cancer survival rate is 63%, versus just 8% for late stage cases (accounting for 44% of all diagnoses), which highlights the importance of improving the abysmal CT lung cancer screening compliance of just 4.5%.  

• Saying No to Customers: Epic CEO Judy Faulkner shared why her team tells customers “no” when they want to adopt a module that isn’t ready for their organization (sounds like a nice problem to have). The blog post gives a good peek at the mentality around Epic’s product development, and how “it’s always more complex than the customer thinks it is, because the customer has mental muscle memory and isn’t consciously aware of everything to tell us.”

• Belgium Bans Ozempic for Weight Loss: It’s no secret that patients have been clamoring for GLP-1s, and the risk of shortage is only expected to increase following last week’s FDA approval of Eli Lilly’s Zepbound and Novo Nordisk’s presentation showing that Wegovy can help reduce cardiovascular risks by 20%. Physicians are increasingly worried that the popularity of GLP-1s among patients looking to shed pounds could be keeping them out of the hands of diabetics with fewer alternative options, and Belgium has now gone as far as to ban the use of Ozempic for weight loss amid ongoing shortages.

• Climate Change Deaths: Extreme heat drove 1,651 excess cardiovascular deaths per year in the US between 2008 and 2019, and that rate could increase significantly by 2036-2065 due to climate change. An AHA study detailed two scenarios: a “middle-of-the-road” scenario with a 162% increase to 4,320 annual heat-related cardiovascular deaths, and a more extreme scenario where heat-related CV deaths jump 233% to 5,491 per year – both having the greatest impact on the elderly and Black adults.

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