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Value-based care is the future

Value-based care is the future ‘At the end of the day, payers will only pay if a therapy is working’

Jonathan OgurchakA pharmacist by training, Jonathan Ogurchak has spent the last decade following the concept of value-based care, which all too often, focuses only on inpatient or immediate outpatient settings. 

“There are not the levels of standardized data there where you can see the ability (we have) to provide care for patients,” said Ogurchak, CEO & co-founder of STACK, a pharmacy information management platform. “We’re slowly starting to peel back the layers of the onion where there could be impact and the ability for home infusion and pharmacy to help provide meaningful data points as outcomes that align with the rest of that patient experience that demonstrate the true value we provide. 

Ogurchak will speaking at the National Home Infusion Association’s 2022 Annual Conference in Nashville next month, including hosting two roundtable sessions, “Applying Value to the ‘Value-Based’ Future.” 

HME News: Why is the home care industry behind on gathering and providing value-based data? 

Jonathan Ogurchak: A lot comes down to proving outcomes and proving worth. If you go into a hospital to get a knee replacement, the site of care is right there and the hospital is doing the billing. There’s some type of reimbursement for that one service whereas when you move into the outpatient setting, it’s much more disjointed. Who’s providing the care, who’s getting the reimbursement? Is it the outpatient setting and the pharmacist? Is it the third-party nursing agency?  

HME: Are you seeing more effort to track this data? 

Ogurchak: You can track adherence or tangibles as it relates to dispensing but there aren’t standards. While there are efforts to push for (value-based care), there is a disconnect as far as how those things should and could be tracked for meaningful use. It’s also a bit of a chicken-and-egg scenario: yes, we can develop all these standards but if my dispensing solution isn’t able to capture these values, we’re at a loss. I asked at a (session), ‘How many of you trust your software to able to capture this data?” and no one raised their hand. 

HME: Do you think providers understand the importance of being able to show the value of what they do? 

Ogurchak: At the end of the day, a payer is only going to pay for a therapy if they see it’s working, if it’s proving effective. If they can’t prove it is preventing hospitalizations or progression of disease, what’s the point? We’ve been moving into the concept of data and how do we capture data, how do we provide the information necessary to prove our worth?  

HME: What are some best practices providers should consider when trying to show value? 

Ogurchak: First and foremost, finding ways to integrate those data points into the workflow as much as possible. That’s the sweet spot. For providers that need to capture it for (a certain) payer, it’s a Post-It on their desk, but when you are in the heat of a conversation with a patient, you may forget and miss the opportunity. Second, not overcommitting to certain data points. It’s not realistic. You are not only setting yourself up for failure, but also setting patients up for a bad experience when you are not able to get actionable data.


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