To improve quality scores and patient outcomes, healthcare organizations often need to implement strategies that close gaps in care. When there are gaps in patient care, individuals are more likely to experience negative health outcomes, which can result in readmission, lower quality and satisfaction scores, and increased costs for healthcare providers.
However, closing these gaps is no simple feat. There are numerous factors that contribute to gaps in care, including patient socioeconomic conditions and inconsistent care coordination. To address these challenges, healthcare organizations may want to consider one or more of the following strategies.
Arguably the best way to address gaps in care is by getting patients to face-to-face appointments. This allows medical providers to perform immunizations, order lab tests, and complete other preventive care measures. However, to do this effectively, healthcare organizations must be able to identify patients who currently have gaps in care.
Data plays a crucial role in this process, and healthcare insurance payers can provide key information to medical providers—if payers provide alerts about missed preventive services or opportunities, providers can then follow up with patients in a timely manner.
Healthcare has historically experienced interoperability issues that might prevent this type of payer-provider communication, but modern electronic health record systems have standards for exchanging data based on Consolidated-Clinical Document Architecture (C-CDA), which can facilitate this type of information sharing.
Another way to ensure patients are getting the care they need is by hiring care coordinators. While organizations will have to find room in their budgets to accommodate additional staffing, research has shown that care coordinators often deliver significant return on investment.
For instance, the Texas-based Trinity Mother Frances Health System hired two licensed vocational nurses to serve as care coordinators, and the coordinators were charged with pre-visit planning, care gap management, and care transitions.
According to the American Academy of Family Physicians, the facility’s no-show rate for appointments was down to 2.8% after just six months, and the organization was able to increase the number of primary care visits by 3% from the previous year. While the cost of these care coordinators was $68,400 for nine months, the organization generated an additional $117,528 in net downstream revenue by closing care gaps.
Research has shown that racial or ethnic minority groups are more likely to experience gaps in care, and organizations can better meet the needs of those with cultural barriers and/or limited language proficiency with the help of cultural competency training. Through this type of training, providers learn about cultural issues that may impact the way patients share medical information, how to best treat those with limited language proficiency, as well as how to take cultural backgrounds into account when providing care.
By implementing this type of training, Minnesota-based care system HealthPartners was able to reduce the colorectal screening gap between white and ethnic minority patients by one third in just a year, according to AHIP. The organization also experienced reduced disparities in medication compliance and shorter stays among mental health patients with limited language proficiency.
Patients have different personalities and communication styles, and case studies have found that individuals are more likely to engage with healthcare organizations when communications are tailored to suit their preferences. These preferences can be deduced by psychographic segmentation, which takes into account factors like personality traits, lifestyle, attitudes, interests, beliefs, and more.
According to Deloitte, healthcare organizations should make an effort to understand where patients fall on a spectrum of attitudes and preferences. Targeting patients more specifically along such a spectrum will allow these organizations to better target, attract, and retain patients, and more effectively drive behavior change necessary for better health outcomes and lower cost of healthcare.
Many organizations know what they should do to close gaps in care, but find that the barriers and complexities inherent in the strategies above hamper their efforts to do so. Guideway’s non-clinical Care Guidance services efficiently and effectively close gaps with interventions from trained Care Guides, delivered according to disease-specific protocols, and supported by a comprehensive technology platform that provides a system-wide view of the patient and ensures that the right action is taken at the right time, every time. Care Guidance is proven to be highly effective in bridging the gaps between clinical visits that result in unsatisfactory outcomes, with results that include reducing unnecessary readmissions by 31-49%, producing significant savings in cost of care.