Leveraging Data Tools for Value-Based Contracts

Managing value-based contracts is complex and can be seen as a distraction to caring for the patient. community health centers (CHCs) are challenged with managing data from numerous sources, tracking and meeting multiple performance goals for different patient populations, understanding which patients they are responsible for in a contract, and, most importantly, providing the right care at the right time to the right patient for all patients for improved outcomes. Community Health Care Association of New York State (CHCANYS) collaborated with stakeholders to integrate clinical, enrollment, and claims data from electronic health records, health information exchange (HIE), and payers and is helping CHCs weave the data into their daily operations. Additionally, CHCs collecting social determinants of health data can quickly analyze their impact on performance metrics, identify targeted interventions to improve outcomes, negotiate risk adjustment, and identify resources to support changing care models. This session explores strategies and lessons learned in CHCANYS' journey to harness data effectively, leverage point of care and reporting tools with multiple data sources, risk stratify, and enhance patient engagement to facilitate care management and population health activities.