• Adam Tabriz, MD

Every Medical Practice Will Eventually Need A Data Scientist

A Closer Look At Why Quality And Value-based Data Analytics Is Becoming Beyond Crucial Today, To keep Medical Practices Thriving.

This Article was Initially published by Illumination on Medium!

Photo by Carlos Muza on Unsplash

Since the initial introduction of the value-based physician reimbursement model by the Center for Medicare and Medicaid Services (CMS) in 2008, the medical practice adoption of the payment model has been rather shiftless. According to a May 24, 2022, MGMA Stat poll, only about 40% of medical practices have incorporated quality in their physician compensation procedures.

Even though fee-for-service has invariably been the central reimbursement model for 3rd party private payers, nonetheless, based on a recent report today, seemingly private payers are outpacing the CMS in adapting the merit-based payment scheme.

Among the medical practices, medium to large entities, including Accountable Care Organizations (ACO), constitutes the large portion of the medical practices that have at least partially adopted some form of Value-based payment model.

Based on a report published by the Medical Group Management Association (MGMA), it is clear that medical practices, be it small or large, may have the opportunity to dodge the value-based reimbursement model temporarily. But can not detour it for too long.

Driving Medical Practice Under A Value-based Reimbursement System Requires Data Analytics Resources.

Implementation of value-based reimbursement and quality-driven medical care is an immensely data-intensive undertaking. It is a task that requires ongoing study, data collection, analysis, and reporting.

Collecting data by itself that involves physician medical evaluation and clinical decision-making is already a plus burden. Furthermore, analytics may require adding new skillsets to the staff, adding extra costs to the already burdened medical practice.

A healthcare analytics software costs between $350 to $5,000 per user; the average salary of a data analytics expert may run from $80,000 to $120,000 annually.

Amidst value-based reimbursement, having correct data will ensure maximum payments.

Forty-five percent (45%) of the medical groups, based on the MGMA report, use in-house analysts and software to manage their data collection and reporting processes. Forty percent (40%) reported using in-house analysts, whereas 15% stated they exclusively utilize third-party software.

Medical Practices Need To Clutch The Extent Of Adopting The Right Tools To Address Value-based Reimbursement.

Unfortunately, the reality of imminent value-based reimbursement is inevitable. That concedes the need for a healthcare delivery infrastructure and footing where every healthcare stakeholder, including physicians, medical staff, and patients, can navigate the clinic encounter in tandem, transparently, and interactively. Such a system will ensure not only error-proof data collection but also accommodates fitting data analytics for analysts to accurately determine the quality and value of every patient's clinical encounter. Consequently, the modern infrastructure will enhance the independent physician reimbursement under the merit-based model efficient, affordable, and accurate.

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