The Third Pillar of Transparency: Consistent Data Processing
In related articles, FRG introduced the first and second pillars of transparency, full disclosure and frequent data sharing, a key part of FRG’s core framework that emphasizes the impact of regular data processing and the benefits it has on creating transparency in value-based agreements.
This article will cover the third and last pillar of transparency, consistent data processing.
What is Consistent Data Processing?
In value-based agreements, consistent data processing is fundamental to smooth information sharing. FRG’s team of experts uses stored procedures and control processes to ensure predictable results and clockwork delivery. This approach supports multiple business processes, which often stem from new information. Such processes can include, for example, month-end financial close, updates to actuarial inputs for reserving, payor to practice joint operating conferences, and – perhaps most importantly – provider detailing to activate performance improvement initiatives.
Consistent Data Processing Do’s & Don’ts
Do’s
- Plan file layout changes with a 60-day lead time to allow for documentation changes
- Develop table-driven deal term application models
- Define an input and output document archive strategy for audits
- Set and meet data preparation, transfer, processing, and loading schedules
- Allow retroactive restatement consistent with lags
- Limited incremental data packages in favor of full restatement
Don’ts
- Change layouts without notification
- Collapse large categories of cost into bulk charges
- Overcomplicate contracts: goal levers should be clear
- Change code without a change-control process
- Forget to conform to Substantial Financial Risk requirements and provide clear links to drivers like attachment points, accumulation periods, and over-capped exposure
- Release data from work processes without comparing it to previous cycles and checking for outliers, and reconfirming all inputs were refreshed
How Does Consistent Data Processing Impact Value-Based Agreements?
Agreements that incorporate value-based care concepts unite financial data with quality-of-care service delivery statistics to measure provider performance, and they typically directly impact provider compensation. When compensation is thus at risk, parties need trust to engage. In VBC relationships, FRG believes that transparency builds trust, and that consistent data processing is a core tenet of transparency. Here’s why.
A party to an agreement that affects another’s compensation can build trust through regular communication. When communication is regular, a pattern of understanding will develop, expectations will emerge, and plans will form to address observed trends. If the cycles of information exchange are interrupted or corrupted such that the information shared is inconsistent or incongruent, the aberrations will sow doubt, particularly about the validity of any compensation-related computations. Avoiding this is paramount. As the old adage reminds us, trust is difficult to build but easy to lose.
The trust needed for VBC success has many parts: trust that terms will be followed, trust that information will be shared, and trust that the provider will have a realistic opportunity to manage care to deliver the goals of the agreement. Those at risk in any arrangement with seek to trust and verify. Then repeat.
Further, and beyond trust, timeliness is also critical. Since all compensation flows through the system downstream from the Plan sponsors (government or commercial) to the health plans and then to the providers in risk pools, timing and consistency of data production help to keep the reconciliation rhythm and all the related processes running on time. As described above, consistent data processing helps to prevent unnecessary delays in the communication cycle.
Finally, beyond provider compensation, and most importantly, timely and consistent data processing empowers care teams to act. Many managed populations far outnumber the provider teams. The time-clocked deadlines to record conditions for risk adjustment and perform preventative measures are real constraints to VBC performance and provider success, but they are also linked to member health, which is why regulatory bodies elevate them. When information flow is interrupted, care teams have difficulty identifying which members need outreach. Some need outreach because they need preventive care, and others need outreach because they have experienced a significant episode of care. Their providers can’t respond meaningfully if they don’t have reliable, timely data to set their intervention priorities.
In summary, sharing comprehensive data consistently so that it can flow downstream and drive action and incentives is a key part of transparency in value-based healthcare.
AccuReports: An Application Made to Support the Future of Healthcare
AccuReports, FRG’s state-of-the-art value-based care reporting software, supports consistent data processing, full disclosure and frequent data sharing. FRG processes data for the largest plans in America and serves data to hundreds of providers nationally.
Our team of professionals works hard to help health plans achieve transparency in risk contracts and physician groups manage performance by presenting their quality, operational and financial data concisely for analysis.
Get in Touch with FRG’s Experts!
For any additional information about FRG’s services and their impact on building transparent value-based agreements, email info@frgsystems.com or call 888-466-1025 today.