Value-based Care Can Be More than a Buzzword: Thoughts on Health Plan Priorities

After two long years without travel and limited in-person connections, our team has been back on the road attending industry events and reuniting with customers, partners, and colleagues. It’s been incredibly energizing to be back in person and learn from each other.

In just the past few months, the Diameter Health team has attended several healthcare conferences that put a spotlight on health plan priorities. These events have been incredibly well-attended. Exhibitor halls are full and panel presentations are running long due to attendee Q&As. And while there have been significant advancements in innovation over the last few years of the pandemic, it is clear that health plans are laser focused on what’s next. From reducing health inequities to strengthening provider networks, a top priority is success in value-based care (VBC) programs that address the fundamental question: how can we improve member health outcomes while reducing the total cost of care?  

For example, during a recent event in Orlando, FL, panels and working sessions concentrated on sharing best practices in the shift to VBC, highlighting a few key areas of investment:

Across these presentations, there was one common sentiment: investing in data as the foundation of all value-based care initiatives will accelerate success. Unpacking that further, presenters shared that they are investing heavily in real-time data and analytics solutions that will generate data-driven insights for critical use cases. Must-have features of these solutions: timely, scalable, transparent, and innovative.

One large, national plan shared that, when it comes to build versus buy, they choose to implement “best of breed” technology solutions like Diameter Health’s Fusion that help maximize existing data investments, reallocate skilled resources, and speed time to value. A regional plan spoke about its health equity initiative and shared that, because collecting race and ethnicity data is fundamental to implementing a whole person approach, their focus is on automating the reporting process with digital, high-quality data. Across other sessions, we were hearing plans emphasize the need to invest in data, automate workflows, and integrate insights into the point of decision-making.

This shared understanding of the importance of data expressed in these sessions and in many conversations with health plans at our booth and in the halls has made us hopeful. The investment in data infrastructure – including the use of interoperable clinical data – will be what finally moves VBC out of the buzzword category and into the mainstream.

Reflecting on these events, we are even more motivated to pursue our mission. Diameter Health’s goal is to make data universally accessible, organized, and actionable for better health and a more efficient healthcare system. Clinical data in its raw form is incredibly challenging to use but Upcycled Data™ – clinical data that is interoperable, standard, and fit for use – is positioned to be the accelerator of all value-based care initiatives.  We’ve seen our customers leverage clinical data as an asset across proactive care management, HEDIS/quality reporting, risk adjustment, AI/ML model development, and more to reduce operational cost and drive revenue, while improving member health and engagement.

So, back to the question: how can we improve member health outcomes while reducing the total cost of care? We strongly believe that investing in solutions to acquire and transform data into an interoperable asset will help us get there.

We hope to see you at an upcoming event soon. To learn more about Upcycled Data and why it matters, click here.

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