Population Health ―the new buzzword in healthcare
You can’t be a healthcare professional in today’s healthcare climate without hearing or reading something about population health on a daily basis. Population Health, Patient Engagement, Patient Outreach, Population Management, it’s everywhere; HIT publications, medical journals, websites, conferences, emails, and webinars. It’s no coincidence. There’s a good reason for all the hoopla. As we transition from a fee-for-service payment system to a value-based, outcomes-driven system, the financial risk is shifting from traditional payers to those delivering the care. The bottom line – payers can no longer afford to support fragmented, uncoordinated, and wasteful healthcare spending. For a care team to succeed with the onslaught of changes in healthcare, regulatory mandates, and an ever-growing level of quality reporting, healthcare providers need a solution that enables them to deliver collaborative care and effectively manage the health of the patient population.
Value-based care is here and there’s no turning back
I am probably not telling you anything you haven’t heard before. But, like everything else we hear over and over again, we have the tendency to tune it out. However, here’s where the rubber hits the road. The honeymoon is over. The days of the incentives for meeting MU, PQRS, and VBM quality programs ended in 2014. Effective January 1, 2015, the penalty phase began, the details of which warrant its own volume. HHS has set clear goals and a timeline for shifting Medicare reimbursements from volume to value. The point being that value-based care is here to stay and that means providers need the right tools to ensure improved health outcomes for their patients, especially those with a chronic condition.
They used to call it “disease management”
Beyond basic disease management, managing your chronically ill patients has become far more complex. The goal is to initially identify those at-risk patients, starting with those patients with chronic conditions. They are the most frequent utilizers of medical services and, subsequently, the most costly to treat. Even if these patients are seen, they may not be complying with their treatment protocol or taking their medications. Being paid for outcomes or paid for performance means providers need to take control to better engage patients to ensure compliance.
Engaging patients for better outcomes
A growing body of evidence shows that patients who are more involved in their own healthcare experience better health outcomes and incur lower costs. As a result, many public and private healthcare organizations are employing strategies to better engage patients. NextGen Care™, our new population health and care management solution, is designed to streamline the care team’s workflow, manage the patient population more effectively and efficiently, drive better outcomes, and decrease overall cost of care delivery, as mandated by new value-based payment incentives. This solution provides holistic patient data to the entire care team, making it easier to access vital information and coordinate care, ultimately helping to improve care quality and medical outcomes. Download the NextGen Care brochure.
Predict, prioritize, prevent
Do you really know who your patients are? Before a practice can deliver appropriate care to the patients who need it most, high-risk patients must be identified. For instance, today’s diabetic patient may have been pre-diabetic last year. Not only is this patient likely to be sicker today, but also costs more to treat than a year ago. Managing your patients means you need to know how they’re doing and how you can better engage them. It’s important to understand the disease burden; who has what, what they have, and how many other patients in your practice share the same condition. Risk stratification and analytics, such as the services offered by Milliman provide actionable insights and point-of care-alerts. This enables care team members to easily identify gaps in care, automate outreach, and manage specialist referrals; especially for patients with chronic conditions.
Keeping all the balls in the air
There’s no question these are particularly challenging times for healthcare providers across the entire spectrum of care. That said, NextGen Healthcare works to provide solutions that enable long-term success for our clients. Sharing ideas and information helps to make our clients more successful, more satisfied, and most of all, more effective. We call the result of all this partnering the NextGen Nation™. And all providers are welcome to join.
Read the NextGen Care press release here.