Population health insights

New certification furthers quality mission

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Mar 19, 2014

Philips was founded on the premise of improving quality reporting for providers. Dating back to PQRI, we foresaw the expansion of value-based care, and began developing a solution that could aggregate and normalize data and automate quality reporting for providers.

 

We knew it was important that the platform could scale, and we were surely right about that.

 

Today, there are few healthcare organizations of any size that aren’t being touched by a value-based care payment model, be it from commercial or public payers.

 

More than a decade on - platforms to gather, read, analyze and report the right measure sets of data for the many different incentive programs or payer models a given system navigates - must continue to innovate and anticipate market demands.

NCQA certification for IHA’s VBP4P program

As quality, performance metrics and population health management continue to intertwine and become highly specialized, worthy health IT platforms need to maintain market prominence.

 

The Integrated Healthcare Association (IHA) administers a precise value-based pay for performance program in California. Its model utilizes equally precise HEDIS measures on health plan administrative functions. This is in addition to traditional HEDIS measures on provider performance.

 

We’ve achieved NQCA certification for this program, on a measure set ranging from prevention activities to medication and chronic care management to resource utilization. The performance tracking aims to ensure high levels of logic review, advance reliability of performance measurement data and enable our healthcare organization customers to provide consumers and purchasers with consistent and comparable information. (This speaks to another trend we saw coming, patient engagement and consumerism.)

VBID as a new era of care

Through these health plan-specific measures and through IHA’s own mission of bridging healthcare stakeholders, the California VBP4P is advancing value-based insurance design (VBID).

 

We believe VBID is the intersection of personalized medicine and population health management, and we already support multiple customers embarking on health system and employee health plans. This certification will further our abilities nationwide.

 

VBID can take on many forms, but to simplify it, foundational VBID incentivizes patients to seek the specific types of care they need. And platforms like ours help providers identify just what those needs are.

 

That’s personalized medicine on a population scale.

 

In IHA’s program, providers and provider groups submit data to IHA for assessment, after which the health plans pay bonuses based on performance and in part on the merging of clinical and administrative functions leading to new measure sets.

 

We’re gratified to have met this certification milestone and further the twin pillars of value-based care and value-based insurance design.

About the author

Niki Buchanan
Niki Buchanan, 
General Manager & Business Leader, Philips
Niki Buchanan is General Manager & Business Leader for Philips PHM. A dynamic and versatile healthcare executive, Niki uses her distinctive customer satisfaction and product optimization methodology to lead improvements across the Health IT spectrum.

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