Industry groups release playbook for data-sharing in value-based care

Providers and insurers working in the value-based care space, fear not: There’s a new playbook in town meant to guide you on proper data-sharing standards.

Three healthcare industry groups—America’s Health Insurance Plans (AHIP), the American Medical Association (AMA), and the National Association of Accountable Care Organizations (NAACOS)—released the 36-page playbook on July 25. Adoption of the best practices in the playbook is voluntary; the playbook is intended to encourage the adoption of value-based care arrangements in the private sector, according to a news release from the three groups.

Under a value-based care model, providers are reimbursed based on patient outcomes rather than the quantity of services provided like in the traditional fee-for-service model. The value-based care model has been around since the late 1960s, but widespread adoption has been slow—less than half of the primary care physicians said in a 2022 survey from the Commonwealth Fund, a nonprofit focused on health policy research, that they had received any value-based payments.

“The success of value-based care hinges on delivering the best care, in the proper setting, at the right time,” Clif Gaus, president and CEO of NAACOS, said in a statement. “To do that, clinicians need timely, actionable data. Our recommendations for both policy and private industry data-sharing aim to ensure sustained success and growth of value-based care.”

The five main guidelines in the playbook are:

1. Use consistent content and exchange standards to create an interoperable data ecosystem. This simplifies and expands data-sharing.
2. Share complete, accurate, and consistent data that provides a comprehensive picture of a patient or patient population.
3. Collect and share data that identifies and addresses health disparities and barriers to care outside the clinical setting. Ensure transparency, appropriate use, and confidentiality of data.
4. Share focused insights and data early, often, and in accessible ways.
5. Disclose how data is collected and the origins of the data. This creates trust among value-based care participants.

Representatives from AHIP, AMA, and NAACOS met over the last several months and interviewed experts to create the guidelines, according to the news release.

“This is not a product produced in the ivory tower. Rather, this playbook reflects the contributions from physicians on the front lines of implementation, across all practice settings—small, independent to large integrated systems,” AMA President Jesse Ehrenfeld, said in a statement.

The playbook is the beginning of an ongoing partnership between the three industry groups to advance value-based care, the groups said.

“The playbook represents collective effort and shared responsibility, with the goal of reshaping the healthcare landscape, empowering patients, reducing operational burden, and driving positive change,” Matt Eyles, AHIP’s president and CEO, said in a statement.