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Rapid, flexible care is cost-effective care—even in a pandemic
As the COVID-19 pandemic began to spread across the U.S., in North Texas, we turned to data to guide rapid decision-making. Responding to this crisis requires comprehensive, longitudinal data—and full visibility—across our healthcare system to identify who and where our patients are, what they need, and when they need it. It’s population health management 101.
But what was the real secret ingredient to effective population health in a pandemic?
An early transition to value-based care—including full global risk agreements—enabled our teams to have the necessary member insights and to respond both rapidly and flexibly while maintaining high-quality care. Withcommunity physicians and our academic and acute-care founding partners, UT Southwestern and Texas Health Resources, working side-by-side, we can track our patients from home to primary care to acute care and back again, and design interventions at appropriate points along the full continuum of care.
Within the first weeks of the pandemic arriving in the U.S., our clinically integrated network was able to care for patients and support the physicians who care for them. First, we looked at our members who were not COVID positive. We could see they were not all getting the care they needed. Emergency department visits were down for everyone except those with the virus. Data also revealed a dramatic uptick in strokes and cardiac arrests at home. The people we serve were afraid to seek care and risk exposure—even when other causes threatened their lives.
As all healthcare systems prepare for a new normal, key learnings from the COVID response of our network can guide us all forward. These actions will be vital in providing necessary and routine care until the pandemic is under control—and beyond:
The infrastructure that enabled these rapid responses to COVID also allows us to take on full-risk value-based agreements with payers and better support our physicians. For the fact is, our pandemic response would not have been possible under fee-for-service agreements. It would not have been possible if care management had been outsourced and disconnected from our analytics and processes.
Healthcare has been slow to assume full risk in value-based care models. The majority of VBC agreements are still shared savings and minimal risk and quality metrics, with the expectation of full-risk models stuck at “someday.” Yet, here in North Texas, taking on full risk enabled a multi-pronged, patient-centered, cost-effective response to an unprecedented crisis.
Because full risk value-based care isn’t just about taking on all the risk of the cost of care, it’s about doing the right thing for members—even in a pandemic. And when you have the visibility, the infrastructure, and the commitment to do that, the quality of care rises and the total cost of care drops.