Breaking Barriers in Value-Based Care: Insights from the Frontlines

Last September’s Innovations in Value Based Care (VBC) conference was a whirlwind of critical discussions on challenges, innovations, and solutions. The conversations circled around a crucial question: How do we make value based care work for everyone? 

The Big Picture: Collaboration, Technology, and the Whole Person 

The overarching theme? Collaboration is key to making value based care successful. Providers, payers, and service organizations must work together to achieve the holy trinity of VBC: reduced costs, improved care quality, and enhanced client experiences. 

Technology emerged as both an opportunity and a challenge. While data fragmentation continues to be a stumbling block, the power of AI, analytics, and even wearable tech was emphasized as vital in managing risk and personalizing care. The key takeaway? Choosing the right technology is critical for success. 

There was also a strong emphasis on “whole person care,” including health-related social needs (HRSNs) and addressing clinical and behavioral health. But the biggest challenge? Overcoming weak tech infrastructure and engaging community-based organizations (CBOs), many of which are not equipped with advanced technology but play an essential role in building client trust. 

Data Dilemmas: From Silos to Streams 

Unsurprisingly, data interoperability was a recurring theme. It remains a major headache. Despite efforts to improve data flow, data silos remain a major pain point. 

A key discussion revolved around the disconnect between existing systems and on-the-ground realities. One burning question: Will screenings, consents, assessments, and referrals flow smoothly between systems? The jury is still out. 

Dr. Joseph Conte, Executive Director of the Staten Island Performing Provider System (SI PPS), injected a dose of realism, cautioning against overly complex systems prone to failure. His domino analogy was spot-on: if the first few steps go wrong, the whole system crumbles. 

Success Stories: Practical Solutions to Value Based Care Challenges 

Despite the challenges, there were inspiring examples of how some organizations are navigating value based care complexities. From comprehensive pandemic response efforts to improving access to food pantries and addressing primary care gaps for chronic issues, such as asthma. These success stories show that practical solutions are possible. 

One promising area of innovation is Fast Healthcare Interoperability Resources (FHIR) Bundles for seamless data exchange. While FHIR adoption will be a significant undertaking for many Social Care Networks (SCNs) and CBOs, it represents a crucial step toward improving data interoperability and care coordination. As SCNs and CBOs evolve, adopting FHIR standards will be key to unlocking seamless data exchange across systems and improving outcomes across clinical, social, and behavioral health care. 

Community-Based Care: Building Trust and Capacity 

CBOs play a crucial role in the success of VBC. They are often the trusted link between Medicaid members and healthcare providers, particularly in underserved communities. Expanding the capacity of CBOs is a major goal of the NYHER 1115 Waiver. However, ensuring they have the right tools and tech infrastructure is still a significant hurdle. 

Looking Ahead: From Challenges to Opportunities 

From streamlining RFP (Request for Proposal) processes for home remediation to simplifying screening and eligibility for underserved populations, the need for practical, user-friendly solutions to simplify workflows is key to moving forward. 

As we continue to build out value based care, there’s a growing need to prioritize data visibility, real-time feedback mechanisms, and workforce adaptability to create a system that works for everyone. 

Takeaways for Social Care Networks 

For SCNs, the key challenges will be ensuring smooth data exchange, adopting the right technology, and strengthening collaboration with CBOs to provide holistic, whole-person care. The conversations at the conference highlighted the importance of these steps in transforming care delivery. 

Value based care has the potential to revolutionize care, but only if we overcome the challenges ahead. With the right tech infrastructure, collaboration, and focus on whole-person care, we can build a system that delivers on its promise for clients, providers, and payers alike. 

What We Can Do for Value Based Care 

At Foothold Care Management (FCM), we are dedicated to empowering Health Homes, Social Care Networks, and Community Based Organizations to track outcomes comprehensively across clinical, social, and behavioral health. Our platform helps organizations meet the demands of value based care by providing real-time data insights, streamlining care coordination, and fully integrating health-related social needs into care planning. We look forward to continuing the conversation and supporting your journey toward a more efficient, value-driven care platform. 

To learn more about how we’re supporting Social Care Networks and value based care stay up to date with us here.