From the September 2017 issue of HealthCare Business News magazine
By: Ann Meehan
The transition from fee-for-service to value-based care and reimbursement is at the top of major health care industry leaders’ lists of trends and challenges for 2017.
Health care experts often debate what it will take to make the transition successful in the new payment model, discussing everything from care models to technology solutions. However, the integrity and trustworthiness of the health care organization’s data and information should be a main focus of these discussions. This is why information governance is imperative.
Information governance provides the formalized framework around all decisions about information collection, use, reporting and sharing. Given the evolving world of technology, health care organizations can no longer assume that their information is accurate and usable and, therefore, should direct their efforts toward implementing this framework. Organizations must put the best policies, procedures and processes into place as an organized approach to manage information and to make more informed clinical and business decisions. It is their ethical obligation to do so.
AHIMA’s Information Governance Adoption Model addresses every aspect of managing and overseeing decisions around information.
A strong IG program is particularly important to the nuances we are finding in value-based care programs, or those that reward health care providers with incentive payments for the quality of their care provided. These programs are part of our larger quality strategy to reform how health care is delivered and paid for, providing better care for individuals, health populations and lowering costs for all parties involved.
Trustworthy data and information are at the center of what is required for value-based care in order to provide quality care, address care coordination, consistent follow-up and reporting of required data to CMS, as well as other payers who follow suit. A formalized information governance program provides the infrastructure around all data and information decisions to ensure that a provider can offer quality patient care and meet all reporting requirements.
Value-based care programs have been in place in various models for a number of years, including the: Hospital Value-Based Purchasing (HVBP) Program; Hospital Readmission Reduction (HRR) Program; Physician Value-Based Modifier (PVBM) Program; and Hospital Acquired Conditions (HAC) Program. New programs, such as the Alternative Payment Models (APMs) and Merit-Based Incentive Program (MIPS), are expected to be implemented in 2019.
