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Topic: Risk-Based Contracts & Cost Performance

EFS Risk-Based Contracts: total cost of care, RAF and value-based performance.

Part 2: Is Your Care Coordination Solution Improving Patient Reported Outcomes — And Bottom Line?

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Part 2 of a 2-part series In Part 2, we will dive deeper into how the care coordination principles discussed in part 1 have been shown to boost practices’ bottom lines, and specific strategies aligned with each area. In our last post about this topic, Is Your Care Coordination Solution Improving Patient Reported Outcomes – And Bottom Line? We discussed the demand for care coordination and the basic tenets of the term. We also uncovered an important business opportunity that lies within the appropriate implementation of care coordination measures – the positive impact that such measures can have on a practice’s bottom line. So how, then, can your practice achieve some of these net-positive outcomes by improving your care coordination? 1. Deliberately organizing patient care activities enables consistency in process and reduction of waste and delay that is often accompanied by unnecessary variability. Historically, standardization has had negative connotations in care delivery, because every patient has a unique history and every provider strives to be sensitive to that when constructing a care plan. The most successful organizations define a best-fit care pathway and manage patients along that path, documenting variances as they occur and continuously re-assessing both resulting outcomes and financial performance. Reducing internal variability in the care process positions the patient for consistently better outcomes, and the hospital organization for sustainable success. 2. Sharing pertinent, contextual patient care information among all care team members allows directed decision-making. The best communications have both a timely delivery and a human touch. Enabling automated communications, like a message to a patient letting them know their request for appointment has been processed, provides the quick feedback that consumers and patients crave in today’s fast-paced world. And empowering providers to make informed person-to-person communicates, by alerting or reminding them to call a patient who indicated they may not be feeling well, ensures that both the provider and the patient get the most out of their conversation, and all goals and needs are met. 3. The best care pathway is crafted using patient-specific data to uniquely tailor the care experience. Early identification of patient risk acts as a trigger point or evaluation that enables a level of care matched most appropriately to a level of risk, ensuring your most intensive resources are best targeted towards the most acute patients. This allows for the “sweet spot” between care standardization and care personalization to be achieved. 4. Patient information is used to provide optimal appropriate and effective care to the patient. Actionable data points are collected, secured, and readily available for monitoring care delivery performance, quality and outcomes performance. What doesn’t get measured doesn’t get improved, and as the USDHHS states, “collecting, analyzing, interpreting, and acting on data for specific performance measures allows health care professionals to identify where systems are falling short, to make corrective adjustments, and to track outcomes.” These measures can be hard to track in a global EMR when they are often changing – like Patient Reported Outcomes which are tested, validated and published in new versions frequently. Leveraging these principles best positions organizations for outcomes success and financial success, but it is difficult to do within the constraints of the EMR. Increasingly, providers must turn to a more agile solution for the results they need, and few solutions offer the agility or user-friendly patient experience to produce results and help you seamlessly track and manage them. A single platform that enables increased practice efficiency, improved outcomes and decreased cost at every step of the care process will help to ease these common practice management and care improvement pains.
Is your care coordination and outcomes management process saving your team time and money? Contact Guideway Care to learn how you can optimize the care coordination process using the Sequence platform and our support services including the NurseLine and Medical Call Center. HIMSS Portrait HK Hayley Kenslea, Director, Product Management Hayley ensures that our technology delivers for clinicians, patients, and systems by coordinating the work of our technical teams and client services. Our product knowledge expert and workflow engineer for Pathways and Call Center services, she joined Guideway Care with almost 10 years of experience in physician practice management, workflow re-engineering, and EMR and BI optimization. Hayley earned a Bachelor of Arts in Psychology & Global Health from Emory University and a Master’s in Healthcare Administration from the Johns Hopkins Bloomberg School of Public Health.

Is Your Care Coordination Solution Improving Patient Reported Outcomes – And Bottom Line? (Part 1)

Written on . Posted in Blog.

The term care coordination is becoming increasingly prevalent in every aspect of health IT, from HIPAA to patient satisfaction. The Agency for Healthcare Research and Quality defines care coordination as: “Care coordination involves deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care. This means that the patient’s needs and preferences are known ahead of time and communicated at the right time to the right people, and that this information is used to provide safe, appropriate, and effective care to the patient.” Few would argue about the importance of the concepts noted above, and the potential positive impact those can have on both quality of care and patient outcomes.  What the success some early adopters of value-based programs shows us, though, is that improved care coordination can also result in better business outcomes for physicians and practices.  While fee-for-service payment methodologies remain a stronghold, to many providers it may seem counterintuitive to redesign care processes for the smaller percentage of payments driven by quality, or value. By choosing the right care coordination tactics, though, practice improvements can be made that positively impact outcomes regardless of specific payment methodology in question. So how, then, can your practice achieve some of these net-positive outcomes by improving your care coordination?

First, let’s discuss some of the specific aspects of care coordination that positively impact patient reported outcomes.

  1. Deliberately organizing patient care activities – Using proven evidence-based clinical protocols, and layering in the necessary administrative steps through which a patient must be managed – registration, appointment scheduling and attendance, and billing and accounting – enables consistency in care delivery and reduction of waste and delay that is often accompanied by unnecessary variability.
  2. Sharing information among all participants concerned with a patient’s care – a shared, meaningful and contextual view allows providers to make quick, informed decisions on patient care and communicate all pertinent details to colleagues on the care team, providing an accurate view of patients’ progress in real time.
  3. Patients’ needs and preferences are known ahead of time and communicated at the right time to the right people – Patients are assessed early and often on a number of different facets, and their response data is used to uniquely tailor their care experience to their needs and manage their risk at the most appropriate level.
  4. Patient information is used to provide safe, appropriate, and effective care to the patient – Actionable data points are collected, secured, and readily available for monitoring care delivery performance, quality and outcomes performance, and more.
Selecting cost-effective, achievable measures to track your progress towards your care coordination goals will save time and money, allowing you to increase efficiency and improve patient-reported outcomes at every step of the care process.

Care Coordination and Return on Investment

As reimbursement models incorporating outcomes measures continue to take hold across all points of care delivery, the demand for dedicated care coordination solutions continues to grow.  Whether you are a self-employed clinician or a hospital CFO, it is likely that one of your goals is to measurably improve patient outcomes, without incurring additional undue costs.  The published return on investment for care coordination varies wildly, from a net-no-return to, in some cases, over 600 percent. Those models that have shown the most efficacy have emphasized patient and caregiver education, standardization of care protocols, multidisciplinary provider collaboration, and a focus on patient management particularly around care transitions and follow-up. Larger investment has not necessarily been shown to result in better return, but rather a more targeted approach towards a narrower patient population.  In Part 2 of this blog series, we will explore this in more detail.
Is your care coordination solution and patient outcomes management process saving your team time and money? Contact MDnetSolutions to learn how you can optimize the process through MDMessenger, Pathways, and our concierge services including our NurseLine and Medical Call Center. Or call us at 888.986.3638.
Hayley Kenslea, Director, Product Management HIMSS Portrait HKHayley Kenslea ensures that our technology delivers for clinicians, patients, and systems by coordinating the work of our technical teams and client services. Our product knowledge expert and workflow engineer for Pathways and Call Center services, Hayley joined MDnetSolutions with almost 10 years of experience in physician practice management, workflow reengineering, and EMR and BI optimization. Hayley earned a Bachelor of Arts in Psychology & Global Health from Emory University and a Master’s in Healthcare Administration from the Johns Hopkins Bloomberg School of Public Health.