Population health

Maximize Success in Value-Based Payment Models  

By Scott Gucciardi

Blog    Maximize Success in Value-Based Payment Models  

How do you leverage data analytics and population health management to deliver value-based care in your healthcare organization?

Reaping the benefits of value-based care payment models requires effective use of population health analytics. Providers can achieve better quality of care, lower utilization costs, and earn incentives through performance improvement tied to contract requirements. 

Snapshot of the Data World 

A dashboard of mainstream and advanced data analytics gives providers and care management teams a snapshot of quality measures and gaps in care, risk of patient readmission, along with expected utilization of care for patients based on predictive risk analytics. 

Risk stratification can be used to identify the patients with the highest likelihood to impact the quality and utilization goals in the value-based care contract. This process informs the allocation of scarce care management resources to the patients who will impact outcomes most.

Close Gaps in Care and Increase Quality 

From the perspective of overall practice operations, gaps in care can be closed, and changes can be implemented to advance quality performance. In terms of quality, it’s helpful to understand that the essential component is a team effort. This applies beyond the providers within the practice and extends across the continuum of care for patients. 

Instead of measuring quality on a broad scope, focus on 10–12 key quality measures at a given time that concentrate on a particular improvement opportunity. These measures can have commonality across programs, such as payer arrangements that help drive the measurement, management, and improvement initiatives for the practice.

Measures for quality need to make clinical sense and be patient-centric. One approach is to implement a set of specific measures that, for a limited time, focus on a quality improvement initiative. For example, the measurements can concentrate on enhancing workflows, closing care gaps, and evaluating processes to ensure favorable outcomes. 

Real-time measurements of quality metrics help avoid surprises. The key is to use a proactive, ongoing measurement process as opposed to a retrospective review of past performance. 

Through integration in the EHR workflow, providers can review an overlay with actionable multisource data analytics. They can click on the overlay in the EHR  for a single sign-on to full patient profile in the analytics application. 

Advance Cost Efficiency 

Community health organizations can manage costs related to low-value care, unwarranted variation in how care is delivered between providers, and the under/over misutilization of resources. Essentials to achieve cost efficiency include risk adjustments, integration with clinical information at a patient level, and cost-quality integration at the provider level. 

Sustain a Resilient Healthcare Organization 

NextGen Healthcare helps CHC/FQHCs in their efforts to provide quality care and successfully allocate and manage limited financial resources. With data that monitors the pulse of the local, regional, state, and national healthcare, community health organizations can:

Access vital information at the point of care 
Select a care management model that is sustainable 
Measure the effectiveness of care management 

“As your practice ascends on this risk curve, the need for analytics and population health management capabilities equally becomes more sophisticated,” says Scott Gucciardi, SVP, Solutions, NextGen Healthcare. 

Learn more from the experts

To deepen your understanding of using data analytics, watch this webinar that features Brian Murphy, director of research, Chilmark Research and Scott Gucciardi, SVP, Solutions, NextGen Healthcare.


Scott Gucciardi

Senior Vice President, Business Development

Get in touch with Scott