Healthcare execs say EHRs don’t do enough to manage value-based contracts

Dive Brief:

  • A survey of 100 healthcare executives found that most of them are seeing ROI on value-based contracts, but investments in EHRs are not sufficient to manage those contracts.
  • The Sage Growth Partners study found most respondents were not satisfied with their EHRs’ “ability to help them manage core functions necessary to succeed in (value-based care) — such as care coordination, risk stratification, decision support and patient engagement.”
  • About two-thirds of respondents said EHRs are not delivering promises concerning lower costs, better population health management and improved patient and physician satisfaction.

Healthcare providers are increasingly looking to EHRs and third-party population health management solutions to help them with value-based care.

A recent Healthcare Financial Management Association (HFMA) survey found that value-based payment programs doubled since 2015. Nearly three-quarters of executives in the HFMA survey said their organizations achieved positive financial results, including return on investment, from value-based payment programs.

Although providers expect value-based programs to continue to increase, the new Sage Growth Partners survey found dissatisfaction with EHRs and concern they are not helping enough in value-based care. The report found 64% of respondents said EHRs haven’t delivered many critical value-based tools. At least 60% of respondents said they are looking for value-based solutions beyond EHRs.

The survey included a finding that will likely get the attention of EHR and population health management vendors — half of respondents said they are somewhat or highly likely to switch population health management vendors over the next three years.

Nearly three-quarters of survey respondents have had an EHR for at least three years. About half also have third-party population health management solutions. These findings offer a glimpse into the dissatisfaction as well as opportunity in population health management.

The executives surveyed said there are issues with interoperability, addressing social determinants of health, patient engagement, stakeholder coordination and risk analytics. They also spoke of health systems having trouble aggregating and using data from numerous EHR systems and other data sources.

These issues have led half to two-thirds of healthcare executives turning to population health management or do-it-yourself solutions beyond EHRs “to compensate for the lack of these capabilities within their EHRs.” Many of those executives said population health management solutions enabled their value-based success. Those successes are also coming at a lower cost than the investments in EHRs.

The study authors predicted more healthcare executives will look beyond EHRs in the coming years to help with value-based contracting. They said “suboptimal tools” that manage care and costs for populations won’t be enough in coming years.

“As (value-based care) reaches the tipping point, and as they take on programs with greater risk and greater complexity, they will need to continue looking beyond their EHRs to get the functionality they need,” the authors wrote.


9 ways hospitals can reduce debt

Healthcare reform has had a dramatic impact on hospital reimbursement. While millions of Americans are now insured under the Affordable Care Act, high-deductible health plans can leave patients cash-strapped after expensive episodes of care. Sometimes, patients can’t pay for the services they receive, pushing up bad debt at hospitals. At the same time, hospitals are dealing with lower reimbursements and a shift from inpatient to outpatient care, leaving some with property and beds that are no longer financially productive.

Take Community Health Systems for example. Burdened with $15 billion in debt , the Franklin, TN-based hospital chain sold a four-hospital joint venture and spun off 38 hospitals into a separate entity, Quorum Health Corp., earlier this year. Recently, the system inked deals to sell an additional 17 hospitals.

According to Patrick Pilch, head of BDO Consulting’s healthcare advisory practice, many hospitals and health systems don’t have a complete handle on what their costs of care are and they’re losing money as a result. “Understanding your costs of care as well as your cost of capital is imperative,” he tells Healthcare Dive. “Then align that to a future strategy. That’s where you’re going to pull your way out of debt.”

Hospitals should look at their assets, business plan, market and supply chain and then see how those align with their capital strategy, Pilch says. With interest rates expected to rise, non-investment grade hospitals will have a harder time getting capital. “If you have a lot of capital that’s not performing well, you’re in a bit of a state right now,” he adds.

Here are nine ways hospitals can work on debt: