Can Real-Time Data be the “Roy Kent Effect” on Value Based Care and Outcomes Management?

The empirical question about Value Based Care (VBC) models and pay-for-performance programs in healthcare is, “do they actually improve outcomes and effect real change in care quality for all patients?” The optimist in me reflects on how far we’ve come from an era where volume overshadowed value on nearly every measure. From this perspective, I believe that the various models and programs pushing providers and organizations to close care gaps have significantly improved care quality. However, the pessimist in me remembers how far behind we were when the concept of value over volume was first introduced. This skepticism surfaces when I think of quality managers handing providers lists of open care gaps at the end of a performance year. What could possibly be done in those last few days to improve care? No wonder our healthcare system often feels like a perpetual “work in progress.” 

Just as the best soccer teams can’t maintain top status by sticking to a single style or formation, even if perfected, the pursuit to improve healthcare quality in the U.S. requires flexibility and adaptation. Government and private payer VBC programs have established some structured tactics with various requirements that can lead to significant financial incentives. Organizations that fail to meet these requirements effectively subsidize the incentives for those that do. While these programs have laid foundational pathways for closing care gaps, it’s now up to the players to move the ball forward. 

Much of healthcare operates on a performance year basis from January 1st to December 31st, or a fiscal year from October 1st to September 30th. When we talk about managing quality outcomes, we refer to the performance year. Measuring care quality annually is crucial for several reasons. One is understanding the true complexity of a patient population. Each year, a patient’s healthcare needs start anew as a blank slate. During annual physicals or wellness visits, providers discuss family health histories and chronic diseases, creating the patient’s complexity story. This data is then used in various ways: payers designate payments more accurately, organizations understand their patient populations better, and patients have a thorough, consistent healthcare maintenance history, which means fewer traumatic, life-changing, and costly health events. 

Consistently managing outcomes by closing care gaps throughout the year is critical to making significant progress. We know that managing outcomes—whether for preventive care like BMI screening or disease-specific actions like diabetes management—has helped. But more substantial improvements in care delivery require more than monthly performance score reviews. Most providers didn’t enter medicine to spend their time staring at screens, having a computer dictate each step of care delivery. Real-time data can strike a balance, allowing providers to meet patients’ needs without being overwhelmed by administrative tasks. 

Real-time data offers organizations options for more efficient communication of open care gaps in a way that works for their providers and caregivers. For instance, a daily huddle report listing open care gaps for that day’s visits can be viewed on a computer, emailed to providers, or printed out and handed to them. This approach lets providers avoid sifting through multiple screens and data fields to identify open care gaps, allowing them to focus on patient care. A daily huddle report provides a concise list of directives, enabling efficient use of time with patients. Open care gaps can be addressed in the first few minutes of the visit, allowing the provider to focus on the patient’s specific needs for the rest of the appointment. 

The difference between delivering a list of care gaps to a provider at the end of the performance year and using a real-time huddle list of open care gaps is significant. Access to real-time data, whether on a screen or in hand, is the advanced footwork our healthcare providers need to advance quality care effectively. Real-time data is the dynamic method of stimulating change through various channels and styles of care delivery, moving healthcare forward.