Value-Based Care model has been widely adopted in both Commercial and Medicare spaces. While the model intends to restructure the healthcare with the overarching goal of value for patients, providers and payers, it introduces new challenges in terms of the business frameworks, risk arrangements, operational strategies as well as performance evaluations. This presentation walks through the framework used to set up a VBC risk contracts as well as business considerations.
Patient segmentation is one of the key functions in value-based care. By analyzing patient data like demographics, utilization, health conditions as well as social determinants of health, providers can identify distinct patient groups with similar needs, following with customized care management strategies to effectively and efficiently manage the population health.
Clustering approaches has been widely used to differentiate groups based on similar patterns. We will review different clustering algorithms used in Value-Based care, such as supervised and unsupervised. Different techniques of clustering will be introduced under the real-world application of business cases.