share information with other organizations
within their system. In many cases, EHRs have
differing iterations that don’t always integrate
and work alongside one another—meaning the
information required for population health is
However, Oneonta providers have a strong
foundation with the clinical data in EHRs. By
marrying this data with other data, they can
begin to feed advanced population health
efforts. Social determinants of health, for
example, can be aggregated and added to
a longitudinal record to help educate patients
and determine those who may be most at risk.
From the payer perspective, Oneonta does
not have one primary payer. Because of this,
healthcare organizations may have a hard time
developing a cohesive value strategy or manag-
ing disparate data from payers to drive toward
a value-based relationship. Analytics play a key
role in solving this challenge and can be used to
understand various patient populations. These
insights enable providers to approach payers
with value-based contracting suggestions that
offer favorable results for both parties.
Showing a strong quality story helps providers
in markets like Oneonta become a part of the
narrow networks that payers will create to drive
patients to low-cost efficient providers. With a
strong knowledge of performance, providers can
move forward and negotiate with confidence.
Looking across New York State, another market is operating with the same value-based
goals within a drastically different landscape.
Manhattan is a bustling New York City borough
with a population of roughly 1. 7 million. While
this market has a high payer breakdown like
Oneonta, it also has high competition and EHR
chaos compared to the rural community.
Compared to markets with less competition,
providers in competitive markets with disparate
technologies are likely to need a more proactive
strategy than less competitive markets, with
the challenge being alignment and engagement.
Patients are willing to switch care for lowered
costs and enhanced service. So, providing convenient, personalized care to attract and retain
patients is key.
To anticipate patient needs, providers are
ramping up use of digital tools such as telehealth, health apps, patient portals, etc.
Patients are likely to return to a hospital or
other care provider where they had a positive,
engaging experience. Not only can organizations in this type of market leverage strong
analytics beyond EHR data to help them engage
in meaningful ways, but they can also extend
value beyond bricks and mortar. Keeping sick
people at home through engagement and
coaching, or through devices that help predict
and prevent health escalations, drives down
costs for high-risk populations, such as patients
with chronic conditions.
While organizations in Manhattan with high
EHR chaos share interoperability concerns with
those in rural markets, the lure of collaboration is
present. Interoperability across the board is critical, but in a highly competitive market, improving
care quality and the patient experience through
improved sharing of data differentiates one
organization from its competitors.
willing to switch
care for lowered
to attract and