Digital Health Strategy for Value Based Care | Q-Reviews

Digital Health Strategy for Value Based Care | Q-Reviews

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  The Digital HealthStrategy for Value-Based Care Accelerating Success in Value-Based Care Through Digital Transformation Learn More: https://q-reviews.com/ Schedule a Session with our Digital Health Strategy Team: [email protected]
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  SECTION 1 ExecutiveOverview SECTION 2 Digital Transformation Strategy Framework for VBC SECTION 3 Driver of Success #1: Promoting Preventative Care SECTION 4 Driver of Success #2: Strengthen Preferred Provider Network SECTION 5 Driver of Success #3: Tackling SDoH Challenges SECTION 6 Driver of Success #4: Data Transformation and Collection SECTION 7 Driver of Success #5: Managing Care Transitions SECTION 8 Toolkit for VBC Digital Transformation Accelerating Success in VBC Through Digital Transformation Q-Reviews.com
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  Executive Overview In recentyears there has been a push for digital transformation in the value-based care terrain in the healthcare, to accelerate the savings and outcomes yielded to date. While enticing, there needs to be a clear strategy and assessment process for VBC entities to determine if digital transformation is appropriate. Additionally, how digital health fits to current efforts that meet clinical, operational, and financial goals. Value-Based Care has been part of the healthcare landscape, before it became a buzzword Due to the pandemic, value-based care has been a phrase adopted by many as a talking point to push for innovation and care transformation. The phrase “value-based care” has concrete pillars and a complex definition that have existed for years. Below is an overview of the value-based care landscape. The Premise 93% of Medicare spending is attributed to the managing chronic conditions The Basics Population Health Value-Based Care focus to improve clinical outcomes and manage costs for a specific population financial agreements and models within healthcare to drive population health initiatives and efforts The Tenants Care Delivery Reimbursement Risk Stratification focus on quality outcomes through preventive and chronic care payment based on quality & appropriateness of care segmenting patients based on their total health profile There are several payment models and organizational structures that exist in the Value-Based Care ecosystem ü Accountable Care Organizations ü Capitation ü Bundle Payments ü Medicare Advantage ü Downside/Upside Risk ü Hospital Value-Based Purchasing ü Patient Medical Centered Home ü Merit Based incentive Payment System ü ACO REACH Accelerating Success in VBC Through Digital Transformation Q-Reviews.com
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  The Structure tothe Strategy To ensure that value-based care organizations undertake an intelligent and methodical digital transformation, they should evaluate the value digital tools have compared to currently deployed efforts within their organization. The best way to do that is to look at what factors make VBC entities successful clinically, operational, and financially. Then understand if any of those success factors can be achieved, improved, or accelerated with the introduction of a digital solution. There are common drivers of success, regardless of model, that have led to repeatable success in value-based care Future direction of value-based care and need of digital health Changes in the payer/provider relations, workforce turnover and recruitment, and narrowing fee for service margins will require VBC organizations to see if current success factors benefit from digital transformation. To make this evaluation process easier, organizations can determine if technology can either automate, deflect, or optimize the above drivers of success across clinical, operational, or financial efforts. Accelerating Success in VBC Through Digital Transformation Promoting Preventative Care 1 Strengthen Physician and Preferred Provider Network 2 Tackling SDoH Challenges 3 Investing in Data Transformation and Collection 4 Managing Care Transitions Across the Care Continuum 5 Shift specific manual efforts, to allow workforce to tackle additional tasks Minimize inbound volume of tasks, requests, and orders Improve the efficiency of how processes and strategies are being delivered Automate Deflect Optimize Impact from Digital Health Transformation Purpose of E-Book: Outline a methodical approach to intelligently integrate digital solutions into your value-based care efforts, by mapping how each VBC driver of success can benefit from automation, scaling, optimization Q-Reviews.com
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  Success Driver #1:Promoting Preventive Care Preventative medicine is a core component to succeeding in value-based care and population health. Regardless of your organizational structure, there are key preventative performance measures that lead to an increase in reimbursement. But there is a larger impact on the overall quality and total cost of care for patient populations. The core benefit of preventative care is to identify rising risk in patients before they develop chronic conditions. Early identification of risk will allow for earlier clinical intervention, leading to better health outcomes and curb future higher costs attributed from chronically ill patients. A study showed that MSSP ACOs that beneficiaries that have their first annual wellness visit saw a reduction in total cost of 5.7%. Understanding Promoting Preventative Care Components Technology Solutions that Fit with the Driver of Success Digital Solution Acceleration Impact (Deflect/Automate/Optimize) Digital Solution Impact Telehealth Platform Optimize Quickly connect with patients to do check-ins Patient Engagement Platform Automate Proactive, automated outreach to educate and remind of screenings and vaccinations Wearables/RPM Optimize Early identification of clinical symptoms to drive patients to preventative services Chatbots Deflect Allow patients to get health questions answered EHRs Optimize Create alerts when preventative services need to be completed Preventative Screenings Vaccinations Wellness Visits and Management Accelerating Success in VBC Through Digital Transformation Q-Reviews.com Key Takeaway: VBC organizations need to find ways to identify care gaps in preventative care quickly, and have solutions in place to increase patient access to preventative interventions
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  Success Driver #2:Strengthen Provider Network Regardless of the value-based care model your organization belongs to, there will always be a large, intricate network of providers responsible for different aspects of patient care. When we think of providers, it is very common for us to think about physicians. The truth is the provider network consists of a diverse range of constituents. This is needed manage the entire care journey and meet all the clinical needs within a managed population. This is defined in value-based care as- Preferred Provider Network. PCPs are paramount to the Preferred Provider Network and success of a value-based care organization. They are directly or indirectly drive many of the clinical and financial goals of a value-based care organization. Top performing value-based organizations have a 7% higher utilization in PCPs services. Understanding the Components that Strengthen Provider Networks Technology Solutions that Fit with the Driver of Success Digital Solution Acceleration Impact (Deflect/Automate/Optimize) Digital Solution Impact EHRs Optimize Central source of truth for patient information to make physician coordination easier Scheduling Tools Deflect Patients can get schedule care on their terms Tech Enabled Specialty Clinical Services Optimize Augment referrals with tech companies that have clinicians on staff, preventing gaps in care to tuck the patient back to PCP Virtual Scribe Automate Ease documentation burden and give physicians more time and capacity Symptom Checker Deflect AI tool patients can leverage to scale referrals to appropriate level of care Wearables/RPM Optimize Identify rising clinical issues so providers can quickly intervene with appropriate care Patient Engagement Platform Automate Proactive, automated messages and education to remind patients about booking care PCP Visits PAC Utilization Network Referrals Advanced Care Professionals Key Takeaway: VBC Organizations must find ways to keep the Preferred Provider Networks easily connected, so patient hand offs are not lost and gaps in care don’t occur Accelerating Success in VBC Through Digital Transformation Q-Reviews.com
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  Success Driver #3:Tackling SDoH Challenges The non-clinical factors that surround a population’s environment have tremendous impact on their health. SDoH challenges not only directly impact patient outcomes, but also create roadblocks at times for value- based organizations to reach, engage, and manage patient populations. Uncontrolled management of SDoH are strongly associated with increased costs to value-based care organizations. Patients with unmet social needs have 10% higher annual health expenditures, approximately $2,443 per year. Outlining the Components that Constitute SDoH Technology Solutions that Fit with the Driver of Success Digital Solution Acceleration Impact (Deflect/Automate/Optimize) Digital Solution Impact Omnichannel Surveying Automate Assess the SDoH needs of patients Multilingual Translators Deflect Increase clinical education and comprehension Patient Engagement Platform Automate Proactive outreach with resources and education, for patients with limited resources Community Asset Aggregator Automate Route patients to community resources based on SDoH gaps Telehealth Platform Optimize Meet patients where access is challenging Transportation Apps Automate Help patients where distance prevents access to care Wearables/RPM Optimize Monitor patients’ health who have access challenges Natural Language Processing Automate Understand patient needs directly from their voice, overcoming literacy gaps Digital Farmacy Optimize Food for medicine to address food insecurity Economic Stability Education Healthcare Access Neighborhood & Environment Social & Community Context Key Takeaway: VBC Organizations must find ways to analyze, assess, and address the SDoH challenges that pertain to their patient populations, and invest in non-clinical interventions beyond social service referrals Accelerating Success in VBC Through Digital Transformation Q-Reviews.com
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  Success Driver #4:Data Transformation & Collection Data is a driving force for any healthcare organization. With value-based care entities, data is fundamental even before one can get involved with population health or an alternative payment model. Much of the analysis completed to even assess the feasibility of a value-based care organization is driven by data. The importance of data transformation has long term impact on the success of a value- based care organization. Data transformation is paramount to analytical transformation and risk stratification, which in turn will impact the payment, operational, and care transformation efforts at times, separately, and very often, jointly. The quality and extent of data sources being ingested to drive transformational changes of a value-based care organization, can be biggest barrier at times. Richness of data and information for risk stratification can be the difference between success or failure for value-based care. Component Essential to Data Transformation and Collection Technology Solutions that Fit with the Driver of Success Digital Solution Acceleration Impact (Deflect/Automate/Optimize) Digital Solution Impact EHRs Optimize Single source of data to empower all functions of organization Wearables/RPM Optimize Collect wider set of clinical data, outside of site of care Health Information Exchange Optimize Connect data across the patient journey that can have disparate data systems Patient Engagement Platform Automate Collect more qualitative data that can be incorporated in risk stratification Mobile Health Apps Optimize Collect wider set of clinical data, outside of site of care Omnichannel Surveying Automate Collect more qualitative data that can be incorporated in risk stratification Natural Language Processing Automate Capture more HCC codes to improve risk stratification Claims Data Clinical Data Cost Data Key Takeaway: VBC Organizations must invest in improving data quality and increasing data sources, to drive better analytics that will provide better insight for clinical, operational, and financial teams to succeed in VBC Accelerating Success in VBC Through Digital Transformation Q-Reviews.com
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  Success Driver #5:Managing Care Transitions Care transitions across the care continuum span from site of care, discharge, post-acute, to the final transition to home. Patients within a population can find navigating the care continuum challenging and often get lost. Many times, value-based care organizations themselves struggle tracking where patients are across the continuum. This impacts overall success of a VBC entity. If PCPs serve as the coach or GM of the clinical team in a VBC organization, then care coordinators are the quarterbacks who run the clinical plans for all the patients in the managed population. Care transitions across the continuum come with a focus of navigating patients to the right resource at the right time. This driver of success is pertinent to patients of all levels of risk, adding the challenge of creating a range of care plans. Understanding the Components for Managing Care Transitions Technology Solutions that Fit with the Driver of Success Digital Solution Acceleration Impact (Deflect/Automate/Optimize) Digital Solution Impact Health Information Exchange Optimize Quickly identify where a patient is across the care continuum, to tackle readmissions Wearables/RPM Optimize Identify risking risk from clinical readings to quickly intervene and prevent readmissions Patient Engagement Platform Automate Proactive, automated outreach to educate and remind how to manage chronic conditions at home Mobile Health Apps Deflect Connect, monitor, and track patients where they are along the care continuum Tech Enabled Specialty Clinical Services Optimize Fill care gaps with clinical services that could be outside preferred network Community Asset Aggregator Automate Connect patients with community resources to better care management and address SDoH issues Telehealth Platform Optimize Meet patients where and when they need help Care Management Readmission & ED Revisits Monitoring and Tracking Chronic Care Management Key Takeaway: VBC Organizations should appreciate the intricate and delicate nature of a patient population’s care journey, and develop an infrastructure that helps managing care transitions Accelerating Success in VBC Through Digital Transformation Q-Reviews.com
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  Toolkit for Value-BasedCare Digital Transformation Step by Step Framework to Assess Current Digital Health Gaps and Align to Value-Based Care Strategic Drivers of Success ü Step 1: Create a Digital Health Governance Team that is Multidisciplinary ü Step 2: Look at Each Success Factor ü Step 3: Pick the Top 2- 3 Factors that are Core to Your Organization’s Value-Based Care Strategy ü Step 4: Focus on the Components in your Chosen Success Factors that Yield Greatest Returns for your Value-Based Care Goals ü Step 5: Recruit Front Line and Leaders Responsible for Each Success Factor to Help the Evaluation Process ü Step 6: Then Analyze if Scaling, Automating, or Optimizing is the Desired Acceleration Impact for the Success Factor Chosen for your Organization ü Step 7: Then Pick the Corresponding Technology Aligned with the Acceleration Impact ü Step 8: Establish an Evaluation Process Corresponding Technology Vendors ü Step 9: Use the Following Checklist to Consider and Evaluate Tools Depth of integration capabilities with current EHR Enhancing Interoperability Connecting Disparate Tech Systems Does Not Add Manual Workflows After Tech Implementation Ability for Customization and Personalization to Workforce Staff Solutions can Address Different Risk Stratified Patient Segmentations Allow for Human Workforce to Operate Outside of Technology if Needed Provide Data that Enhances Analytic Functionality for Organizations ü Step 10: Establish a Proof of Concept with Chosen Vendors to Understand and Identify Challenges and Changes that Need to be Made with the Technology Accelerating Success in VBC Through Digital Transformation Schedule a Session with our Digital Health Strategy Team: [email protected] Q-Reviews.com