Health Tech: Rahul Sharma On How HSBlox’s Technology Can Make An Important Impact On Our Overall Wellness

HSBlox is focused on enabling value-based care. Value-based contracts are predicted to cover nearly 65 million Americans by 2025. The percentage of the insured population in value-based contracts is expected to grow by 10% per year from 2022 to 2025.

There are five necessary components to a successful VBC ecosystem: 

1. Broad access to care for everyone
2. Payment models that reward health improvement over volume
3. Leadership and professionalism of healthcare workers
4. Robust infrastructure that supports complex hierarchies, data capture and sharing needs
5. Unified, permission-based access to patient LHRs (Longitudinal Healthcare Records)

It is important to understand that successful implementation of value-based programs requires a purpose-built value-based administration platform that provides complex hierarchy support for onboarding, data capture, digitization, and exchange. A network essentially consists of the providers, facilities, suppliers, and organizations that a health insurer or risk-bearer has contracted with to deliver healthcare services to patients. This creates very complex many-to-many relationships when an entity in one network is engaged in several networks with different contractual engagements with other entities. A network of networks is possible only with an infrastructure that supports both the complex hierarchies between these entities.

However, the transition from a volume-based transactional billing model to one that incorporates financial risk tied to the patient’s health outcome is not an easy one. There is a need in the industry for a platform that supports a solution that is not “rip and replace” and can augment the existing infrastructure to support VBC programs, including specific use cases like SDoH (social determinants of health), value-based payments, quality reporting and others.