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从表面上看，在提供者和保险公司等承担风险的实体之间整合医疗服务是朝着人口健康管理和基于价值的目标迈出的重要一步。然而，即使是垂直整合的单元也倾向于围绕病人护理单独发挥作用。因此，患者在接受治疗、购买保险以及更多的事情之间分散开来——这种情况降低了患者的体验，阻碍了最佳结果，并干扰了基于价值的目标。然而，一些组织正在弥合医疗保健实体之间的差距，通过一种可持续的、协作的人群健康模式来提高护理风险患者群体的质量并降低成本。通过联合和使用分析来驱动决策和规模规划，真正一体化的风险承担实体将患者置于护理的中心，以更高效、更经济的方式满足他们的医疗需求。

Despite the widespread use of population health as a solution to control rising costs and poor outcomes, healthcare organizations struggle to effectively achieve population health success. A common barrier to success is lack of access to data about a system’s most impactable patients, their interventions, and how said interventions impact a patient’s health. However, health systems can overcome the following all-too-common population health mistakes by leveraging detailed data about their most impactable patients and interventions:1. Lacking an effective solution for data-driven strategy.2. Using delayed analytic insight to understand performance and opportunities.3. Not tracking member-level data to measure intervention effectiveness.

Medicare patients make up the majority of health systems’ revenue; yet, organizations earn only a one percent profit while caring for this population. Despite historically low profit margins, Medicare can be lucrative for health systems, and through the Medicare Shared Savings Program, healthcare organizations can increase revenue with four tools:1. The ability to aggregate and analyze data.2. The ability to align financial incentives between payers and providers.3. The ability to engage patients in behavior or lifestyle modifications.4. The ability to garner support from clinicians and encourage them to lead the shift to VBC.As the shift from fee-for-service to value-based care continues, health systems can leverage MSSP to deliver the highest level of care while also increasing profit margins.

The U.S. healthcare market projects that by 2022 90 million Americans will be in an ACO. The upward trend in population health management (PHM) makes the move towards risk-based contracts increasingly urgent for health systems. The industry has been largely unprepared for the shift, as it hasn’t established a clear definition of population health or solid guidelines on transitioning from volume to value. Organizations can, however, prepare for the demands of PHM by adopting a solution that manages comprehensive population health data, provides advanced analytics from new and complex challenges, and connects them with the deep expertise to thrive in a value-based landscape.

A series of revolutions has driven the development of the U.S. healthcare system, enabling dramatic improvements in all aspects of healthcare quality and outcomes over the past century. Although healthcare organizations have focused on moving towards value-based care for decades, the data shows that the shift is indeed taking place and fee-for-service models are declining.New changes to the Medicare Shared Savings Program (MSSP) will help drive this change as revisions to MSSP require ACOs to take on more financial risk earlier. This article covers the following topics:1. Important moments in history that led to today’s current challenges.2. Why financial imperatives drive cultural change in our economic model.3. Ways MSSP can help healthcare organizations achieve financial success.4. How to utilize data to develop better healthcare delivery systems.

人口健康和基于价值的支付需求数据来自多个来源和多个组织。卫生系统必须获取整个护理连续体的信息，以准确了解患者在急性护理环境之外的保健需求(例如，初级保健和专家的报告和结果)。卫生系统ehr拥有大量关于医疗保健服务的总体数据(例如，患者满意度、成本和结果)，而HIEs则添加临床数据(例如，记录和交易)，以完善患者护理的总体情况，以及传播信息所需的数据共享能力。通过将HIE能力与先进的分析平台相结合，卫生系统可以利用数据在四个重要的结果改进领域改进过程:世界杯厄瓜多尔vs塞内加尔波胆预测Workflow2。机器learning3。专业services4。Data governance