For a lot of patients, Meaningful Use hasn’t been all that meaningful. Sure, consumers may be able to view, download and transmit information from their individual patient portals, but when each provider and health system they interact with has separate systems and logins, none of which communicates with the others, getting a holistic picture of their health is nearly impossible. And from the hospital and physician side, finding a way to make sense of the financial changes while following care management best practices (using just pieces of this disparate information) has been more than challenging. Most health leaders agree that the path we’re on in healthcare includes a continued emphasis on value-based care programs. If you’re going to succeed, both from a monetary and a value-based care standpoint, you’re going to have to figure out how to build a foundation for success within our organizations.
The problem with current preparedness for value-based care initiatives is twofold, first identifying and then managing those patients who can benefit from value-based care. Statistically, only 5% of patients fall into a high-risk category for multiple, combined health issues but represent 50% of healthcare efforts and spending. How can we determine who these patients are so we know who needs care management the most? And what about the larger percentage of patients who fall into a rising-risk category? These patients may be healthier today, but what are the best ways to engage them in their healthcare maintenance now so they don’t accumulate comorbid conditions or default in managing their current ones, which turns them into those higher risk patients? How can we ensure we’re meeting benchmarks for reimbursement structures? Answering these questions is mainly a matter of creating the right infrastructure.
To be truly ready for the future of value-based care, we need:
- Better reports to help us identify which patients are most at-risk
- To know and follow best practices around how to engage and communicate with these high-risk patients
- To know and follow best practices around how to engage and communicate with rising-risk patients
- To know and follow best practices around how to engage and communicate with lower risk patients as well
- More integrated care coordination efforts that can combine multiple EMRs and portal information
- The ability to communicate with patients across a variety of mediums beyond the four walls of the doctor’s office – email, text, portal messaging, even social media – to save time-consuming phone calls for the patients that have the most need and least support elsewhere
Value-based care requirements and fee structures from CMS are going to continue, and though we don’t yet know 100% what that structure will look like, putting the technology in place to handle the big tasks – care coordination, engagement, messaging, access to and use of health data – will put us in a better place to handle the sea changes. When we embrace these efforts we’ll be in a better position to reap the benefits of the new payment models.
Influence Health offers a comprehensive care management platform that allows care teams to identify and create care management and patient engagement programs for all levels of patients, every step of the way, from design to execution to measurement of success. Available as a stand-alone solution or integrated with our enterprise patient portal, which provides innovative and consumer-focused design and applications, we have the technology to make care management more efficient and profitable.
Read the full report on value-based readiness from HealthLeaders Media to discover how you’re positioned against the competition in preparedness.
Image data credit: Center For Financing, Access, Cost Trends, AHRQ. Household Component of the Medical Expenditure Panel Survey, 2010