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Technology’s Role in the Shift Towards Value-Based Care

Value-Based Care is an increasingly popular healthcare model in which providers receive reimbursement that reflects the outcome of the patient. This concept emphasizes the importance of improved patient health and accordingly benefits providers who are able to deliver to their patients. The traditional “Fee-For-Service” model which involves flat rate payments irrespective of patient outcomes or care quality has grown out of favor.

The move away from a purely profit-focused model and towards a patient-centric model highlights the trend of developments in the US healthcare industry. This seismic shift towards Value-Based Care is not possible without some of the modern health tech innovations which are at the forefront of the movement.

The move towards Value-Based Care

For quite some time, the healthcare industry was known as a purely profit-based industry. In order to shift the care focus towards the patient outcome, the Centers for Medicare & Medicaid Services (CMS) has laid the groundwork for various Federal Acts that incentivize providers who adopt a value-based model. The most notable of these was the 2010 Affordable Care Act (ACA). This aligns with the “Triple Aim” framework promoted by the CMS:

The increase in concrete support from the Federal Government influenced many providers in shifting to a Value-Based model.

Why Value-Based Care?

The attractiveness of the Value-Based structure can be attributed to its numerous benefits for both patients and providers. This model is highly popular amongst patients as it highlights provider accountability for the outcome of their care. Patients can achieve peace of mind knowing that the improvement of their health is the primary goal.

For providers, this model offers a larger patient outreach while handing out incentives for better performance. The increased use of technology has helped practices use reliable data to make informed business decisions. While this structure is inherently appealing for all parties involved, the advancement of technology has fueled its widespread acceptance.

Achieving Value-Based Care through Enhanced Care Journey Mapping

Enhanced Care Journey Mapping involves the tracking of patient activities throughout their care process. It is used to conceptualize the process and eliminate any tedious or redundant tasks. Journey Mapping is a prime example of Value-Based care as it seeks to improve patient outcomes. Providers can identify areas where patients face inconvenience and take measures to address them. By analyzing the overall care journey, providers can optimize the patient experience.

What technology solutions are involved?

The large-scale move to a Value-Based Care model has been made possible by the following solutions:

- Telehealth: Telehealth involves the exchange of virtual health services (such as video conferencing) using an electronic platform. The emergence of telehealth software has given patients high accessibility to quality care. Providers can open a new revenue stream while staying up-to-date with their patients, even when a physical meeting is not possible.
- Remote Patient Monitoring: Remote Patient Monitoring (RPM) is a healthcare practice that uses technology to monitor patients in a virtual manner. RPM allows patients to monitor their health daily and encourages them to be more involved with their care. The adoption of RPM services can be directly attributed to a decrease in readmission rates. RPM gives providers valuable insights into the patient’s current condition.
- Chronic Care Management: Chronic Care Management (CCM) involves the facilitation of patients suffering from two or more chronic conditions. Virtual health software services have greatly improved the quality of CCM. Providers save time and money by using these services to connect with their chronic care patients. Patients with chronic conditions can eliminate unnecessary clinic visits and receive timely health feedback from the convenience of their homes.
- Referral Management: Providers have increasingly adopted software systems that streamline their patient referrals. Patients can expect increased efficiency while not having to worry about documentation and processing issues. This has greatly decreased referral leakage which can cost individual practices millions of dollars each year.

Challenges in shifting to a Value-Based Model

While providers across the nation have welcomed the value-based model, some significant obstacles remain before it becomes the industry standard.

Technological Disparities: Many practices do not have the necessary tech infrastructure to operate a value-based model. Many practices lack programs like RPM and EHR Integration, which are integral to the operability of the model.
Government Support: While the CMS has supported many value-based initiatives, it remains to be seen how the Federal Government will include all patients and providers under the triple aim
Financial Risk: This shift, like any large financial investment, comes with a moderate level of risk. Many smaller practices cannot afford to gamble on a move that may not pan out.

Nonetheless, the Value-Based model has shown great promise in bringing change to provider-patient relationships. The response to these issues will determine the success of the model in the long run.

Talk to us to understand more about Value-Based Care and we will guide you to achieve our common goal “Quality Care for All” seamlessly.

How Early Adopters of Healthcare Technologies Are Benefited

Today, healthcare technology has extensively transformed the healthcare sector by changing the lives of many people and also changing the way the healthcare industry operates. It is driving healthcare more than any other force and has resulted in meaningful growth for the future. It has helped the industry by bridging the communication gap between patients and providers.

Though American healthcare providers have embraced the use of EHRs at record-high rates, they lag behind the rest of the world in adopting other digital health technologies such as telehealth, artificial intelligence, etc.

Early Adopters of Healthcare Technology Are Benefitted

There is no denying that the early adopters of healthcare technology are benefitting the most. It is extremely advantageous to providers and has played a pivotal role in bringing noticeable changes to the healthcare industry. There are providers skeptical about the implementation cost and the medical value of technological advances.

Though there remains skepticism among providers about healthcare IT, this situation is likely to change among the U.S. medical providers. Efforts are underway to increase the adoption of healthcare IT and spur innovative solutions. The early adopters are witnessing optimistic results like the ability to provide better care, the reduction of administrative costs, and the power to provide value-based care for their patients.

Some of the benefits are

The adopters are benefitting from the increased revenue government reimbursements for Medicare patients. This allows them to optimize their potential revenue and provide value-based care for their patients.

The adopters have been able to retain and expand their patients through a well-connected care system.

Healthcare IT lets patients have access to their health records, allowing them to take part in their care programs or plans.

With the help of electronic health records, patients have been more engaged in their health and have greater satisfaction with care.

The providers have been able to retain and expand their patient base with value-based care and better results.

Health IT provides 360-degree care which enables both the patients and providers to have a better understanding of the patient’s current health condition and unique healthcare needs thus enabling the physician to come up with individual care plans.

Eventually the adoption of health IT will bring great changes in the healthcare system benefitting both the providers and the patients.

Early adopters, in general, are experiencing the following benefits as well:

Connected health helps patients to self-manage their health thus supporting the physicians for a better health outcome.
Providers are able to retain and expand their patient base while focusing on value-based care
Providers are able to bring in additional revenue by increasing their patient base and aligning with their business strategy.
Early adopters are maximizing their profit through increased revenue government reimbursements for Medicare patients.
Adopting health IT reduces the cost of care for their patients.
The technology behind health IT is advancing rapidly and is transforming the way the industry operates.
Healthcare IT enables the secure exchange of sensitive patient data.
Health care IT has helped to build better patient-provider relationships.
Detailed care - Provides physicians more face time, improved outcomes, focus on preventive measures, reduced readmissions, and reduces paperwork.
Patients will experience higher satisfaction, increased confidence, and enhanced treatment adherence.
Enables better care quality and patient-centered care.

In Conclusion, health IT can tackle the increasing demands on healthcare. It is especially advantageous for the industry considering the increase in chronic diseases and people with multiple conditions. Healthcare technology has the potential to improve the overall outcome by reducing healthcare costs and increasing access to care.

Talk to HealthViewX Solution experts to understand more about their HOPE Platform and solutions like Referral Management, Chronic Care Management, Telehealth Solutions, Remote Patient Monitoring, and many more. Schedule a demo today!

Remote Patient Monitoring helps achieve Healthcare’s Triple Aim

What is Triple Aim?

Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance.

Improving the patient experience of care (including quality and satisfaction)
Improving the health of the populations
Reducing the per capita cost of health care

The Centers for Medicare and Medicaid Services (CMS) has emphasized the significance of achieving the “Triple Aim” objectives. Therefore, the entire healthcare industry is working to harness the Triple Aim concept to enhance overall outcomes.

Achieving the Triple Aim goals is quite challenging. Improving access to care is one of the prime drivers in achieving Triple Aim, which fundamentally helps improve patient experience of care, treatment outcomes of the population and reduce the per capita cost.

Aging Baby Boomers Drain Financial Systems

There are roughly 77 million Baby Boomers in the U.S. (born between 1946 and 1964). Of that group, about 10,000 are reaching age 65 every single day, and that trend is expected to continue into the 2030s.

It is a fact that the Centers for Medicare and Medicaid Services (CMS) cannot afford this increased cost of medical care for this large aging population. The new payment model i.e. the shift from fee-for-service to value-based reimbursement is intended to inspire and reward for providing quality care across the care continuum at a reduced cost. This also helps improve patient health outcomes, patient experience, and reduce readmission rates.

How Does Remote Patient Monitoring (RPM) help in Achieving Triple Aim?

Today, to treat patients remotely healthcare organizations are getting the entire patient data into their systems to get them in front of their physicians and specialists. Innovations and improvements in healthcare technology have allowed patients to survive diseases and get immediate medical attention when most needed. Remote Patient Monitoring is one of the solutions that play a crucial role in helping the baby boomers population, and help healthcare providers to get closer to attaining Triple Aim.

Remote patient monitoring can help providers in value-based repayments through a proactive focus on disease prevention, early involvement, care management, chronic care management, and patient monitoring. This optimized management of care to a greater extent has helped the manner in which physicians provide care and how patients manage their own health.

Improves Patient Experience

Remote patient monitoring along with other Telehealth solutions allow patients to get involved in their treatment by monitoring/updating their vitals, following care plans, diet, etc. This improves patients’ self-awareness of their medical condition and also helps them connect with their provider when needed. The care model allows patients to engage in their care on a day-to-day basis and drives patient adherence, self-involvement, and better health outcomes which means improved patient experience.

Improves Population Health

At times, elderly patients in rural/remote areas find it difficult to reach the providers when in urgent need. There may be several reasons like lack of specialties, distance, etc. In such cases remote patient monitoring can help to a very great extent facilitating medical attention at doorsteps, eliminating long-distance travel, etc. Providing medical care to people of all ages of the especially aging population will help improve the health of the population.

Helps Reduce Costs

This care model will help move from reactive care to proactive care. Providing immediate attention will help reduce readmission rates, reduce hospital admissions, etc. thereby helps reduce the overall cost.

To treat patients remotely, healthcare organizations should adopt and use technologies that help them enhance care experience, improve patient health outcomes, and reduce overall cost.

Schedule a demo and talk to HealthViewX RPM Solution experts and get your RPM started in a jiffy!

Implementing Virtual Care in Referral Management to Enhance Patient Experience

Today, healthcare organizations are working diligently to improve care coordination, care continuity, and patient experience. Among these targets, improving patient experience is the primary goal that organizations want to achieve. Organizations are working towards streamlining processes to smoothen the patient care journey and improve the overall patient experience.

How can you deliver the best experience to patients?

Emerging global health challenges such as Aging baby boomers and increased chronic health issues have placed an increased strain on the existing medical and social services. The US healthcare system is the costliest in the world, accounting for 17% of the Gross Domestic Product (GDP) in 2018. This number is expected to grow to nearly 20% by 2020. [Source: National Healthcare Expenditure Projections, 2010-2020. Centers for Medicare and Medicaid Services, Office of the Actuary.]

Addressing all the three dimensions of triple aim at the same time is crucial. A systematic approach to streamline processes will result in a healthier population, and assure a seamless journey through the whole system of care. A comprehensive automation solution can help simplify processes, and enable the entire system to manage change in a structured manner, paving the way for better patient experience.

Today, one of the processes that would be improved with automation is patient referral management. Patient satisfaction or experience, and quality care depend on effective care coordination not just within the physician’s office but also between physician’s primary health centers, and other care settings (specialty centers, hospitals, health systems, etc.). Using a smart platform for prior authorization, specialists match to alert when referrals need attention and automatically send patient updates to referring providers. This provides them with real-time analytics to gain better insights and also closes the referral loop, which addresses the biggest issue in the referral process today.

Ensuring care continuity and coordination of care for patients by easily scheduling the right specialists will transform the health center to meet the patient’s comprehensive health needs. Increased efficiency of the referral process leads to quality care and better patient experience.

The Use of Video Conferencing in Referral Management

Innovative methods are needed to enhance care quality, improve access to care, and improve patient outcomes. Video conferencing is one such feature that enables real-time two-way video with audio transmission and sharing of diagnostic images, and more. It helps patients to access healthcare services without the burden of travel and receive timely care.

Want to know more? Schedule a demo and talk to HealthViewX solution experts to understand in detail about our virtual care capability in the Referral Management Solution.

Transform Care Journey to Deliver Value-Based Care

The shift from volume-to-value-based is improving patient health outcomes and reshaping the relationship between patients and providers. With the increasing role of technology in the healthcare setting, patients extensively rely on digital sources to stay informed, engaged, and connected with the physicians and specialists involved in their treatment.

This transformation with the use of healthcare technology solutions is progressively gaining importance across all stakeholders in the healthcare value chain, from patients to health systems, and payers. The key reasons are qualitative treatment modules and improved patient care which also contribute to potential cost savings. The transition from volume to value is expected to expand, despite concerns about providers’ slow adoption of technology.

Patient Journey Mapping

Today healthcare organizations are driven by Meaningful Use policies and regulations, meaning they are focusing on understanding and improving the overall patient journey. Both qualitative and quantitative data can be analyzed to improve smooth transition across care settings. This analysis will help providers further improve patient care, satisfaction, and experience.

The current setting has several limiting factors like the below

To stay competitive in today’s constantly evolving healthcare market, providers need to evaluate technology solutions and leverage patient journey solutions to streamline processes and provide excellent clinical care. Implementing processes and programs that deliver timely information will help improve pre and post clinical engagement and can help fill gaps that cause leakages in the patient experience

Benefits of Streamlining Patient Journey

Patients and providers share information at different phases such as appointment scheduling, need for a specialist, or lab test results. Every healthcare organization has hitches that can happen anywhere, starting from appointment scheduling to post-care follow-ups. At each of these points, information flow between physicians, specialists, and the patient should be synthesized.

Patient journey mapping will help in streamlining the workflow, keeping track of the patient’s health conditions, and creating an opportunity for improvements in operations. Overall, it helps improve patient experience and continuity of care.

Talk to HealthViewX Solution experts to strategically build a patient journey map. Unleash the power of the HealthViewX HOPE Platform to layout all touchpoints and goals in terms of healthcare outcomes.

Understand the importance, value and use of Telehealth during this pandemic

Understanding Preventive Care Services

Telehealth has become increasingly important and has seen a striking evolution during this COVID 19 pandemic and is especially capable of having a huge effect on how patients communicate with providers and receive care.

Telehealth refers to a broader scope of remote healthcare services. According to the World Health Organization, Telehealth encompasses, “Surveillance, health promotion, and public health functions.”

The National Consortium of Telehealth Resource Centers has published a video on “Telehealth Policy in a Post-COVID-19 World.” In this video, Center For Connected Health Policy (CCHP) tells what temporary policy changes might remain Post-COVID-19 and what could be issues that policymakers may think merit future action. This will help policymakers, practitioners, payers, and the public understand how to accurately discuss “Telehealth” and its key components.

Understanding the dynamics of Telehealth

Telehealth is presently delivered in 2 major ways:

Video Conferencing (VC) - This is used for real-time provider-patient consultations, PCP-Specialist/ Provider – Provider.

No special software downloads for patients to connect, just click the HIPAA secure link to join the video call, share videos, file, photos, messages, etc.
Patients and providers can connect from anywhere, improved access for remote patients
Easy text or email reminders, easy reschedules, patient self-scheduling.

Remote Patient Monitoring (RPM) - This is used to provide appropriate support for patient self-management and helps in gathering patient data outside of traditional healthcare settings or helps transmit patient health information to health care providers.

RPM Benefits for patients:

No travel expenses and spending time on travel as the in-person visit is not required
Less interference with personal responsibilities like childcare, elder care, etc
No exposure to other potentially contagious patients

RPM Benefits for Providers:

Increased efficiency and revenue
Better patient care and improved health outcomes
Fewer circumstances that lead to no-shows

Importance, benefits, and use of Telehealth

Telehealth provides valuable features that help providers achieve health care’s triple aim – access to care, improved patient outcomes, and reduce cost to the provider. Telehealth removes obstructions of time, distance, and specialty lack. This includes remote, rural, and medically underserved urban communities.

It helps reduce readmissions, stops unnecessary hospitalizations, and ER visits.
It provides peace of mind to patients' family members as they know the patient is receiving the proactive care they need.
It incessantly captures and analyses real-time data and integrates alert algorithms, and helps identify patients who are at risk of emergency department visits (ER Visits) or hospitalization.
It is more reliable, enhances the quality of care, care coordination, saves costs, and time for both the provider and the patient.

Related Article: Role of Telehealth In Chronic Care

How to implement Telehealth:

Implement Telehealth into your existing operation and it has to be designed to complement your standard practices and workflows.

Plan a workflow analysis to reveal how this has to fit in with standard clinical practice.
Consider this technology as another tool for the delivery of normal services with the only difference of the patient being at a remote location.
Keep it simple.

Implementing sustainable Telehealth is the need of the hour. Talk to HealthViewX solution experts to understand how to instantly launch a Telehealth Program into your practice. Schedule a demo today, get up and run quickly, get started in a jiffy irrespective of the size of the operation.