Health care continues to shift toward a value-based care model, where providers focus on preventive care, quality and outcomes. Notably, CMS aims to have all Medicare fee-for-service beneficiaries and the vast majority of Medicaid beneficiaries in value-based care relationships by 2030.
In a recently published article, Dr. McKinley Glover IV, vice president of clinical decision support at Optum Insight, shares the importance of technology in this shift. “At Optum, we’re enabling the transformation by equipping providers with advanced clinical decision support tools (CDS) to help them deliver the best possible care,” he writes.
Dr. Glover outlines three approaches to help ensure more time is dedicated to patients and improving the health care experience:
Artificial intelligence for operations
AI “should inform, not replace, clinical decision-making, patient autonomy and the provider-patient relationships,” Dr. Glover writes. “As AI becomes more integral in health care, it has the ability to drive improvements by delivering information to clinicians to support diagnosis and treatment recommendations.”
85% of health care leaders are exploring generative AI capabilities to improve operations.
Managing chronic conditions with evidence-based support
CDS tools “help physicians stay current with clinical practices” while integrating “vast amounts of data and provid[ing] evidence-based, real-time recommendations at the point of care,” Dr. Glover writes. “They also enable the identification of at-risk populations and support chronic disease management by optimizing treatment plans for patients with multiple conditions. … The complexity of chronic care management further underscores the need for standardized protocols and evidence-based clinical tools to manage care transitions, monitor patient adherence and optimize treatment plans. Overcoming these challenges is critical to improve patient care and reduce health disparities.”
Emphasizing value-based care and payer-provider collaboration
“As we shift from fee-for-service to value-based care models, we need to build a system with better collaboration between payers and providers,” Dr. Glover writes. “By working together, we can better align on incentives and share data to support development of the next generation of advanced clinical decision support tools. … Ultimately, these advanced CDS tools provide a more holistic view of the patient’s health care journey, enabling the development of optimized treatment plans while reducing administrative burden.”
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