TECHNOLOGY GAP IN HEALTHCARE’S VALUE BASED PAYMENT MODEL

Open Access
- Author:
- Hayes, Maris
- Area of Honors:
- Management Information Systems
- Degree:
- Bachelor of Science
- Document Type:
- Thesis
- Thesis Supervisors:
- Dr. Robert Alexander Novack, Thesis Supervisor
Dr. John C. Spychalski, Thesis Honors Advisor - Keywords:
- healthcare
blockchain
value based care - Abstract:
- The misalignment between cost and quality of healthcare in the United States has prompted the players in the industry to reevaluate dated systems and begin to innovate. A common approach to change is the shift in payment models from Fee-For-Service (FFS) to an alternative design; this thesis will focus on the alternative payment model of Value Based Care (VBC). VBC aims to restructure payment by linking payment to quality of care rather than volume; aiming to encourage an improvement in health, care, and costs. However, given the complexity of requirements to execute VBC, significant technology implementation will need to occur. While the required technology exists in other industries, it is not yet integrated in the lagging healthcare industry. Obtaining the proper resources for achieving VBC will have significant investment costs, amplifying the need to correctly identify the proper technology. This thesis will address how investments in blockchain will eliminate the technology gap in VBC. To arrive at blockchain as the solution, the background of payment model shifts will be analyzed through various healthcare player perspectives. The design of VBC operation along with relevant policy and legal constraints will create evaluation criteria to determine the technology needed in effectively executing a VBC payment model. With proper investment and design, the implementation of a VBC model will drive value and innovation in healthcare. The data driven VBC model will require data management systems focused on scalability, interoperability, ease of use, security. The system will need to perform the key functions of information aggregation, analytics, and reporting for both health and financial data. VBC will require digital platforms to be ubiquitous across the care continuum.