Insight by Veritas

Pandemic slowed, but didn’t stop, evolution to outcomes-based healthcare reimbursement

For more than a decade, the Centers for Medicare and Medicaid Services has been moving away from a transaction-based payment modality to a health outcomes mode. The theory is that this will make health care in the long run more economical for the government and better for people receiving health care.

Unfortunately, the pandemic and the response it demanded put a hold on this transformation, according to Rich Bryant, the chief technical officer for healthcare...

READ MORE

For more than a decade, the Centers for Medicare and Medicaid Services has been moving away from a transaction-based payment modality to a health outcomes mode. The theory is that this will make health care in the long run more economical for the government and better for people receiving health care.

Unfortunately, the pandemic and the response it demanded put a hold on this transformation, according to Rich Bryant, the chief technical officer for healthcare at Veritas. The transformation is a data-intensive effort, and Veritas, he said, has been aiding the government in retaining health care provider data in a secure and resilient way.

The covid pandemic has produced whole new data streams from infection reports, contact tracing, and vaccine-related issues. Bryant said the learnings from the pandemic will be pivotal, after it recedes, to improving the metrics associated with underserved populations and lowering healthcare costs.

Bryant pointed out that the Department of Health and Human Services covers 85% of reimbursements for healthcare in a nation that spends nearly 17 percent of its GDP on health. He added that answers for how to curb these rising costs will likely emerge from the large amounts of data the healthcare complex generates.

Telehealth techniques – especially those demonstrated by the Veterans Affairs Department and by the armed services’ medical components – have shown how, in many instances, effective care can get delivered at lower cost than traditional in-person. Bryant said a legislative fix is needed to let reimbursement for telehealth in general continue past the national emergency. He telehealth will only improve with the introduction of internet-of-things devices, medical peripherals connected to smart phones or otherwise able to communicate vital information to remote health care providers.

Bryant also said that the zero trust architectures called for by the Biden administration’s executive order on cybersecurity enables deeper and wider data sharing among agencies with vast amounts of health related data. That in turn will enable more research into outcomes – leading to new efficiencies in health care delivery. But these advances, Bryant said, will require comprehensive data management approaches that include enterprise data governance.

“Veritas, as an enterprise data governance company, can help them with that process,” Bryant said.

Featured speakers

  • Rick Bryant

    Healthcare Chief Technical Officer, Veritas

  • Tom Temin

    Host, The Federal Drive, Federal News Network