Blog: Mark Segal, GE Healthcare:  Medicare is shifting rapidly to value-based and integrated care. Notably,  the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) initiated major changes in Medicare physician payment.  In addition to ending the long reviled Sustainable Growth Rate (SGR) used to update Medicare professionals’ payments, MACRA creates two new value-based programs, which will rely on interoperable health IT (HIT).

Organizations are becoming increasingly dependent on health information and technology to effectively coordinate care, improve health, and manage risk at a population level in today’s value-based care environment. This white paper identifies some of the key strategies, practices, challenges, and opportunities to effectively managing and coordinating care across disparate settings and systems. The paper draws from an executive roundtable that convened 20 experts in January, 2014.

Today’s healthcare system is undergoing radical shifts in care delivery and payment models, transforming the very nature of the care continuum. The imperative to decrease cost, improve quality, and measure and report on outcomes is prompting stakeholders to focus on value-based care through coordinated, patient-centric, and data-driven care delivery. Providers recognize that complex interactions between the varying physical, mental, and behavioral needs of a patient contribute to overall health—and are increasingly seeking to incorporate community and social service entities into the care continuum. Advanced case management technology can help social service organizations collect, integrate, and manage data to deliver high-quality, value-based care to underserved populations while also improving operational efficiency and report for compliance and outcomes. This paper describes the experience of two such organizations, Region 6 Behavioral Healthcare and the AIDS Foundation of Chicago as they implement health information technology to serve their patient populations.

Mark Segal, Ph.D., Representative of eHI’s Policy Steering Committee