Championed by government entities like the Centers for Medicare and Medicaid Services and the Department of Health & Human Services, value-based care is here to stay. Hospitals are increasingly participating in value-based programs—such as the Hospital Readmissions Reduction Program and Bundled Payments for Care Improvement—in an effort to improve care delivery and patient outcomes while reducing the total cost of care.
There’s good reason for the push behind value-based care; poor care quality care may lead to more emergency department (ED) visits and higher readmission rates, thereby resulting in increased costs for providers, payers, and patients. To ensure high-quality care, reduce unnecessary health care visits, and experience the full benefits of value-based care, health care systems must use technology to provide more informed, comprehensive care throughout the patient’s journey. Technology helps hospitals and health systems thrive under value-based care models in the following ways:
Reduced ED visits and hospital admissions
ED visits and hospital stays come at a high cost to providers, payers, and patients. The average hospital inpatient stay costs between $8,000 and $23,000. Likewise, decreasing the number of ED visits – some of which could be treated in a lower-cost setting–could save the U.S. an estimated $32 billion annually. But how do hospitals limit ED visits, and subsequent admissions, while still providing quality patient care?
The answer lies in using technology to its fullest potential. Hospitals leverage care coordination technology to gain better visibility into when, and under what conditions, a patient is admitted to the ED. With this insight, they can evaluate and intervene as needed to recommend whether care should be provided in a less-costly setting.
Care coordination technologies also loop in primary care and post-acute providers regarding shared patients, enabling a patient’s entire care team to collaborate using the same information as the patient makes his or her way through the continuum.
Hospitals can also deploy technology that better addresses patients’ social determinants of health. By tapping into digital care networks, hospitals connect patients with home- and community-based organizations to better address needs such as food insecurity, housing, transportation, and mental health. Addressing these needs proactively helps reduce patient visits and health care costs.
For a patient already admitted to the hospital providers can take steps to determine if they will require post-acute care following the hospital stay. Care coordination solutions ease the process of finding the right post-acute provider by collecting and sharing relevant information among patients, families, and case managers. When collected in one place, this information can be delivered at the bedside to minimize discharge delays and help patients continue on to the next stage of their recovery.
Identifying the right post-acute setting and optimizing length of stay
While many patients prefer receiving care at home after leaving the hospital, that doesn’t mean it is always the right setting to ensure a successful recovery. Discussions regarding a patient’s post-acute care should be ongoing during the hospital stay, and data analytics can help support decisions regarding the needed level of care by considering outcomes of past patients with similar conditions. Analyzing this data enables clinicians to make the most appropriate decision for their patients while mitigating readmission risk and reducing potential post-acute care spend.
Provider involvement in a patient’s care does not end at discharge. The transition from hospital to a post-acute care facility is one of the most challenging; for example, nearly 23% of skilled nursing facility (SNF) patients are readmitted to the hospital within 30 days. These readmissions may stem from inefficiencies earlier in the care transition process, such as a mismatch between patient needs and post-acute provider resources.
With analytical, care coordination and other technological tools in place, all stakeholders can collaborate on a singular platform and can place patients with high-quality providers that cater to their specific needs, monitor those with high-risks, obtain visibility into care delivery from home health agencies or SNFs, and identify – early on – when to follow up with patients throughout their journey.
Technology plays a critical role in achieving value-based care. By bringing together key stakeholders, it has the power to break down siloes, increase communication and efficiencies, connect provider workflows, and enhance visibility into the patient’s journey. Ultimately, technology not only improves care for patients, but also drives efficiency and rewards stakeholders based on outcomes.