A few weeks ago, I was honored to present at the 2018 World Congress Care Coordination & Technology Congress in Atlanta, GA. This unique event brings together executives from all sectors of health care to share strategies and best practices for improving care coordination and patient outcomes through the use of technology, predictive modeling, and population health strategies. The event was attended by more than 600 people and featured seven deep-dive summits, five hands-on workshops and three days dedicated to educational sessions and peer-to-peer networking.

My session focused on optimizing value-based care with integrated analytics and outreach automation and since not everyone could be there, I wanted to share with you the three salient takeaways I delivered to the audience.

  1. Care coordination is complex and requires robust outreach and communication, a well-defined process, and a shared mission across the enterprise.
  2. Sophisticated analytics capabilities are foundational and should be utilized by all members of the value-based care team.
  3. Finally, standalone Population Health offerings are inefficient and frustrating — EHR data is required, and the insights derived must be manually integrated into the EHR workflow.

All that said, let’s discuss what I truly believe to be the fundamental capabilities to thrive under value-based reimbursement:

  • Data aggregation from multiple sources. The delivery of comprehensive, high-quality care requires patient data from sources across the continuum of care. Data should include your practice’s EHR but go beyond it―to encompass adjudicated claims, health information exchanges (HIEs), sociodemographic information, and more. The goal is to achieve a 360-degree view of the patient―integrated, holistic information robust enough to support decision making and care management.
  • Retrospective and predictive analytics. Every member of the value-based care delivery team requires analytics to support their function. The patient care team must understand the big picture of the population they serve, as well as the status and trends of individual patients. Administrative executives need insights to manage operational and financial aspects of care. Marketing teams may use analytics to support outreach campaigns.
  • Patient engagement. Outreach campaigns are critical to the efficacy of care management in value-based reimbursement. To engage patients, you must respect their communication preferences, whether by text, telephone, email, or a patient portal.
  • Care coordination. As you take on greater risk for patient outcomes, effective teamwork becomes a critical practice capability. Value-based care takes a step away from traditional physician-centered care delivery and toward a patient-centered team approach. For this approach to be effective, team members must work together to accurately sequence and route interdependent tasks, as well as understand each other’s responsibilities in care delivery.

I walked away from the conference with a wealth of information, including the fact that 15% of patients with multiple conditions account for 50% of the spend. Secondly, I garnered a greater understanding of how Medicare is incorporating telehealth to support rural areas and areas where there are too few providers, thereby increasing patient engagement and developing a better way to stay in touch with those hard to reach patients.

Participating in thought leadership events allows us all to provide insights on the dynamic changes occurring in healthcare, as well as the distinct opportunity to learn from industry leaders, our peers, and industry influencers.

If you’re looking for additional ways to succeed in the era of value-based care, I encourage you to download our “5 Steps to an Effective and Sustainable Population Health Management Program” eBook.