In the ever-evolving landscape of healthcare, value-based care (VBC) has emerged as a critical pathway to improving outcomes while reducing costs. At the heart of this transformation lies the need to establish financial and quality metrics that not only reflect success but also align with the diverse needs of stakeholders. Despite their importance, defining and implementing these metrics remains a significant challenge for many organizations.
Understanding the Challenges
During Syntax Health’s recent webinar, special guest Barry Steinberg, former executive at Village MD and Elevance, joined Syntax co-founders Rachael Jones and Emily Walker to unpack the complexities of financial and quality metrics in VBC. Together, they identified common hurdles:
Balancing Specificity with Flexibility
“Metrics must be specific enough to drive outcomes but flexible enough to evolve with patient needs and system changes,” Barry noted, emphasizing the tension between standardization and customization.
Data Availability and Accuracy
Emily Walker pointed out, “You can’t manage what you can’t measure. Poor data quality or misaligned reporting structures can derail even the best VBC intentions.”
Alignment Across Stakeholders
Rachael Jones highlighted the importance of collaboration, stating, “Metrics need to be mutually beneficial for payers and providers. Without trust, even the best systems will fail to gain traction.”
Measuring Outcomes Versus Processes
The panel agreed that shifting from process-driven to outcomes-focused metrics is crucial. Barry added, “This shift forces organizations to redefine success and navigate accountability challenges.”
Incorporating Behavioral Health Metrics
Behavioral health integration remains a growing focus, with metrics like depression screenings increasingly prioritized. “These are no longer optional—they’re essential,” Rachael emphasized.
Market Trends Shaping Metrics
The discussion also explored emerging trends driving metric development:
Health Equity: Metrics now emphasize tracking outcomes across demographic groups and addressing disparities.
Patient-Centered Care: Organizations are incorporating patient-reported outcomes (PROs) and experience measures.
Advanced Analytics: Tools like AI and machine learning are enabling metric refinement and customization.
Barry observed, “The market is moving toward simplicity without sacrificing depth. Programs must reduce the reporting burden while ensuring meaningful insights.”
Syntax’s Approach to Bridging the Gaps
Syntax Health has developed innovative tools to address these challenges head-on:
Real-Time Data Analytics: Syntax’s platform provides actionable insights to adjust metrics dynamically.
Collaborative Design: Their solutions align payer and provider priorities, fostering trust.
Behavioral and SDOH Integration: By incorporating social determinants of health and behavioral health metrics, Syntax helps clients achieve a more comprehensive view of care delivery.
“Our mission is to make these challenges manageable by providing transparency and actionable insights,” Emily shared. “We’re not just solving for today—we’re building for the future of value-based care.”
Actionable Steps for Success
As Rachael succinctly put it, “Start with clarity. Know what success looks like for your program.” To that end, the webinar highlighted three key steps for organizations:
Clearly define success metrics early in the process.
Build robust systems to measure and validate outcomes.
Establish mechanisms to adjust metrics as healthcare landscapes evolve.
Bridging Trust, Transparency, and Results
The journey toward effective VBC metrics is challenging but essential. With Syntax Health leading the charge, organizations have the tools and expertise to navigate this complexity and unlock the full potential of value-based care.
To learn more about how Syntax Health can support your VBC strategy, explore our 7-Step Guide to VBC Success or schedule a complimentary session with our advisory team today.