Care Management
Identify situations in which episode management is needed, match the appropriate cross-continuum care plan to the episode, share the care plan with all the care team participants, and provide visibility and certainty in the execution of the plan
Manually cold-calling patients to remind them of upcoming appointments or of bills nearing a due date has never been an effective engagement strategy. On the contrary, such reactive tactics reduce engagement quality and can harm revenue cycles. It\'s important to remember that real connection empowers patients to be proactive in their care and improve their own outcomes, which encourages them to keep up with future appointments and medical payments. For modern healthcare organizations, maintaining this level of high engagement requires more than the automatic actions they’ve grown used to. Instead, the overall healthcare world needs more robust patient engagement to push forward and stay relevant with patients. Without this change, organizations are more likely to encounter skipped appointments, preventable readmissions, missed payments, revenue loss on several fronts, and poor patient outcomes. Fortunately, Experian Health offers a range of solutions that make it easy to engage patients in their care, improve patient outcomes, and create more profitable revenue cycle management (RCM) throughout an entire organization. Using patient engagement technology to improve care As previously mentioned in an Experian Health blog, patient portal technology — among others — is rewiring the technological landscape and capabilities in the physician and patient relationship. Portals are used for secure messaging by 41 percent of family practice physicians, and 35 percent of physicians also use them for patient education. This type of patient engagement technology culminates in our Patient Self-Service portal, which pools together data from our Patient Estimates, Patient Statements, and Coverage Discovery tools. The portal gives patients a single point of access to request estimates, pay bills, check financial assistance eligibility, and receive advice from doctors, nurses, and specialists. The above are just a few results from elevated, proactive patient engagement. Another perk is the portal’s unique ability to automatically populate patient-specific and payer-specific information into each estimate for optimal accuracy. This feature gives patients peace of mind by knowing what their exact out-of-pocket expenses amount to. When they receive a bill that matches the estimates they’ve been budgeting for, patients are more likely to adhere to payment obligations and return to a healthcare organization for future medical needs. This also makes it easier for an organization to collect payment at point of service and throughout the rest of the patient’s care continuum. Risk stratification for more successful revenue recovery For the first time in history, there is a growing convergence of powerful, internet-connected personal devices and massive amounts of analytical, social, financial, and behavioral data tied to individual patients. Experian Health’s timely patient engagement tools allow providers to tap into this convergence to revolutionize how they engage with patients at all points throughout their care. For example, by analyzing patient-specific financial information, this engagement technology can help providers identify when patients may benefit from financial assistance, especially for upcoming treatments. In turn, the provider can send the patient information about how to request for this type of assistance through an interactive portal with accurate estimates. To help reduce readmission rates for non-critical concerns, Experian Health’s tools can also help identify when patients may need unique, targeted engagement. For instance, patients with heart conditions can benefit from information regarding diet and lifestyle changes that improve cardiovascular health. These tools help providers determine the best type of content to send and the appropriate medium to send it through, such as email, text, or app notifications, according to the patient’s specific preferences. By working together with healthcare providers, Experian Health’s solutions combine highly personalized self-service with accurate price transparency and patient-risk stratification to proactively engage with patients. You, too, can be at the forefront of improving patient outcomes and RCM strategy effectiveness by understanding the changing healthcare environment. Utilizing tools, such as a patient portal and others, can position your organization to increase patient engagement and benefit from being a forward-facing healthcare provider.
As healthcare in the United States shifts toward a more value-based model, reducing readmission rates has become one of the biggest challenges healthcare organizations now face. Last year, approximately half of all hospitals in the country collectively lost more than $500 million in reimbursements because they had not learned to overcome this roadblock. In most cases, the difficulty doesn’t stem from provider inadequacy, but rather from the inability to effectively coordinate patient care among multiple providers and departments. From treatment specifics and aftercare instructions to prescriptions and follow-up visits, there are plenty of cracks in the communication pavement for important details to fall through. Here\'s the unavoidable fact: Suboptimal care coordination results in higher readmission costs to hospitals, even for patients with highly treatable conditions. In turn, providers lose much of their profitability, which further hinders their efforts to improve quality of care. Two key (and often missing) factors in care coordination are advanced IT strategies and patient engagement. The only connection among inpatient, outpatient, and long-term care teams is the patients treated in each. Therefore, providers should make it easy for patients to be proactive in their own healthcare. In large part, that requires technology that allows all patients and their care teams to communicate easily and securely, at any time and across any device. Modernizing healthcare communication while reducing hospital readmissions If healthcare providers could simply call or instant message each other with details about patients’ medical conditions, then coordinating care wouldn’t be as strenuous. Without a secure platform, however, healthcare providers might leave sensitive patient health information out in the open for anyone to steal. That liability would be multiplied among numerous physician groups, specialists, skilled nurses, home health aides, and more, possibly affecting several cities and states. All of that is in addition to hazards created by patients who log into public Wi-Fi networks and carelessly leave their mobile devices unattended. There are a lot of elements to consider, but providing a safe and convenient communication platform for patients and their healthcare teams eliminates most security concerns. With a care coordination platform, communication is protected across a broad provider spectrum, no matter what device is used. For example, after a patient is released from the hospital, the Care Coordination Manager generates and delivers real-time messages to members within the patient’s care continuum. These messages, which include discharge details, a checklist for contacting the patient, and schedules for future visits, are automated and delivered within a closed-loop system for optimal safekeeping. Better coordination equals fewer readmissions Closing communication gaps between patients and care teams is a big factor in reducing hospital readmission rates. With this in mind, as a rule-driven platform, the Care Coordination Manager automatically sends email or texts to patients and caregivers about meaningful events. By doing so, patients and their teams stay on the same page at all times with notices for completed test results, newly prescribed medications, and schedule or treatment adjustments. With the platform\'s two-way, real-time communication capabilities, patients can also ask questions and receive answers about their conditions almost immediately. This helps keep patients informed and engaged, and it encourages them to seek self-care solutions rather than visit the hospital repeatedly for minor concerns. In addition, different providers on the team can easily request information from each other. The Care Coordination Manager is unique and requires virtually no additional training for doctors and staff to utilize. The platform offers all of the benefits of secure, automated communication without the time-consuming catch-up training that often comes with implementing new systems and processes. Of its many advantages, however, the most significant is that the Care Coordination Manager patches up the cracks in care coordination and communication where important patient care information often gets lost. When patients and their healthcare teams can connect and discuss sensitive health information without the worry of security and efficiency, the better care becomes. As a result, organizations can reduce readmission rates across the board, which equally benefits patients and healthcare institutions, all while keeping the main goal of providing quality care top of mind.
During HIMSS17, Experian Health\'s Nicole Rogas, Senior Vice President of Sales, sat down with IntrepidNOW to discuss the healthcare industry, challenges providers are facing and women in health IT. Excerpt below. \"...it’s an industry that changes consistently, and Experian Health has the data and the history to be able to arm both our clients, which our providers, and the consumer, which is the patient, with information to help them make better healthcare decisions. We are hearing more about it in IT and as well as other areas of healthcare really nationally. Women do play a very important role in the future of healthcare, and I think the focus on it now brings to light some of the sort of special issues and challenges we face as women that are very different than what man may face as they grow their career. ...a lot of the challenges for our providers is to understand how to function as a business, and I know that that might sound crazy, but healthcare is always been a service, and most of our economies today, most of our people today believe that it’s really their right to (have) healthcare, and I think what’s happening is our healthcare providers are having to function more like a business organization to ensure that they are providing care at really great quality care, but in an efficient way. They are able to build and get reimbursed for that care, and then that they are able to arm their patients with the right information pre and post care to help keep them engaged in both their financial and their clinical journey. So I just think it’s a big time in our industry.\" Listen to the full podcast
There has been a lot of uncertainty with regards to what the future holds for healthcare in the U.S., but the reality is that the move away from transaction-based services where providers are paid by transaction or by interaction with their patients, into a world where some of those services will be paid as bundles, is a reality. At Experian Health, our perspective is that there isn’t going to be one single form of payment. There isn’t going to be only fee for transaction or only fee for value type payments. There is going to be a variety. And our solutions can help providers handle that. When we talk to our largest providers, they want to make sure that they are prepared for the future of healthcare, and that their payment and revenue cycle is robust enough that they can handle whether it is a fee for transaction interaction with the provider or with the patient as well as fee for value. In order to do that, they have to optimize their operations. There is a lot of belt tightening happening in the industry and people are trying to see and understand how best to organize, how best to analyze and facilitate that payment cycle. We believe that data and analytics are two of the key ways to do that. Our software tools as well as the data that we embed into that software helps optimize the revenue cycle. Listen to the complete podcast
On April 27, millions of workplaces, employees, parents and children will celebrate the 24th year anniversary of the Take Our Daughters And Sons To Work® Day program, which encourages girls and boys across the country to dream without gender limitations and to think imaginatively about their family, work and community lives. This national, public education program connects what children learn at school with the actual working world. Experian Health\'s offices will be participating in this program as part of its Women in Leadership initiative. Learn more about it and how your organization can participate.
Below is a collection of some of most compelling article we\'ve read in recent months. We hope you find these interesting, too! One Goal; One Contract: How a Nationwide Health Data Sharing Framework is Revolutionizing Interoperability http://www.himss.org/news/one-goal-one-contract-how-nationwide-health-data-sharing-framework-revolutionizing-interoperability 7 things to know about Aetna\'s ACA exchange exit http://www.beckershospitalreview.com/payer-issues/7-things-to-know-about-aetna-s-aca-exchange-exit.html 5 steps to cybersecurity for Internet of Things medical devices http://www.healthcareitnews.com/news/5-steps-cybersecurity-internet-things-medical-devices CMS: ICD-10 specificity kicks in Oct. 1, 2016 http://www.healthcareitnews.com/news/cms-icd-10-specificity-kicks-oct-1-2016 3 leadership skills crucial for a culture change http://www.beckershospitalreview.com/hospital-management-administration/3-leadership-skills-crucial-for-a-culture-change.html
Scott Lee oversees the Experian Health Reference Program. Scott graduated with a BA in Business Management from The University of Texas at San Antonio, and has been with the organization for 12 years, beginning with MPV, which was acquired by Experian in 2011. Scott lives in San Antonio with his wife and two children and says his second home is the San Antonio Zoo based on how much time he and his family spend there. Scott is a catalyst for fostering the connection between Experian Health’s current and potential clients to allow the former to share their positive experience and ROI using our solutions. Our clients also benefit from being a reference by learning about the workflow and best practices of similar organizations. Because of the importance of protecting our clients’ privacy, Scott schedules calls on behalf of our clients and ensures that the experience is mutually beneficial and minimally disruptive for all parties involved. “We’re very appreciative of our reference clients, and it’s a privilege for our potential clients to hear their experiences firsthand.” he said. Share your story by being an Experian Health Reference Client! Contact your Sales Director/Account Manager or contact Scott Lee at scott.lee@experian.com or (210) 582-6320.
Below is an update from the Experian Health Support Team. Network & System Performance Last six months: Upgrades to the network, compute and storage infrastructure have improved performance and scalability. Enhanced alerting and reporting to strengthen proactive measures for issues remediation Next six months: Data Center move and consolidation will localize production communications to improve efficiencies Automation improvements to reduce on-boarding times for new clients Subscribe to Receive Product Support Updates Opt in to receive emails about significant product updates or changes. Access the Experian Health Product Dashboard here.
Care Coordination Manager is the industry’s first solution designed specifically to help hospitals, health systems, and provider-led health plans succeed with 30-90 day episode management. It is a flexible, rules-driven care coordination system designed specifically for physician groups, hospitals, health systems, and provider-led health plans, whether for ensuring bundled payment profitability, maximizing ACO and health plan savings, managing post-acute costs, or reducing readmissions. Contact us today for more information at 1 888 661 5657 or visit the Care Coordination Manager page.
