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Health Plans

Health plans: Engage providers to maximize analytic investment

January 12, 2017
Connecting financial performance to delivery systems to improve shared savings for everyone.
Dawn Milstead

Your analytic investment is a significant lift. To maximize return on investment, health plans must connect financial performance to point-of-care service delivery. Your providers hold the proverbial keys to success in value-based care. Knowing how to approach them and share analytic insights to improve collaboration and care coordination will maximize your investment and bring improved patient outcomes and shared savings to everyone.

Provider Relationship for Analytics CompanysWe understand and support the high value of provider relationships because we are more than an analytics company. Our clinical and educational branches set us apart, providing critical consulting and support to connect technology and analytics to the care delivery models driving health plan performance.

For example, we can and do, work directly with providers on behalf of health plans to directly engage with them in using the Theon® analytical platform to drive actionable insights to support improvement in care coordination and delivery.

From our direct experience, the following are critical success factors to maximize your return on analytical investments through strategic engagement with your provider community.

Satisfy Physicians

Physician satisfaction is key to adoption and compliance, so placing it at the forefront is of utmost importance.

To support physician satisfaction, include a comprehensive communications strategy for articulating the value of shared analytics in improving value-based outcomes. Be clear about the benefits in time, effort, and quality and cost outcomes that providers and provider organizations can achieve through the use of a unified, shared platform.

Sophisticated analytics can augment existing analytic capabilities to lighten the load through providing timely insights and informing care coordination opportunities to improve admission/readmission rates, quality outcomes, and early identification and intervention for at-risk and rising-risk patients.

Identify Champions

Health plans must endeavor to understand provider organization design from a structural, communication and accountability perspective. For example, knowing who controls influential roles such as expectation-setting and value-based incentive payment flow throughout the delivery system is important. These key leaders are critical to influencing provider adoption, ongoing use of shared analytics and care coordination alignment to improve patient engagement. They are the champions that you must leverage at the outset.

Establish Benchmarks for Everyone

Innovative health plans provide, encourage and support transparency and line-of-sight into practice alternative payment models from the top of the provider organization down to the point of care.  It is critical that providers at the practice level understand their practice-specific roles, metrics and expectations and how their performance compares to their peers. Practice transformation hinges on benchmarks for each provider organization, practice site and even for individual clinicians. When those involved at the point of care are aware of the benchmarks and expectations, then efforts will be better aligned, increasing the likelihood of goal achievement and ultimately patient outcome improvement.

Understand and Respect Provider-Level and Practice-Level Workflow

In our experience, expecting clinicians to exit their workflow to access analytical insights means those insights are wasted. Physicians simply don’t have time to bounce back and forth. Health plans realizing the greatest success in value-based contracts are those that provide analytics that augment the clinical workflow. Our providers generate greater returns on their meaningful use investment because we support them in their current workflow and make it easy for them to access and act on patient-level insights.

Create a Formal Adoption Plan and Listen

As an innovation firm, we fully understand how challenging change can be. We advise our health plan clients to establish a formal technology adoption plan for value-based provider partners. This plan should include technology utilization goals and clear feedback loops so we can listen, understand and proactively provide support for practices struggling with change or those with limited adoption. This type of robust feedback and response loop will enhance collaboration and improve performance.

Become a Valued Resource

Health plans thriving in the value-based environment are those who serve as a valued resource to their provider organizations on many levels. They ensureEstablish A planopen lines of communication and minimize duplication of efforts through formalized partnerships in care planning and coordination across the care continuum. These partnerships align health plan, providers, and care management teams to focus on coordinated intervention strategies for improving the health of attributed patient populations.  Providers need to view health plan disease and case managers as extensions of their own care coordination models.

Assess Needs and Capabilities

Provider readiness assessments help health plans to deliver the right support to the right providers in the right way to ensure thoughtful implementation of shared technology and analytic resources. Because change is hard for people, a broad range of educational and skill training is required to improve your provider's and employee's skills and capabilities to align with the outcomes desired through value-based care.

Provide Ongoing Frontline Support

To sustain success within a value-based framework, health plans and their technology partners should establish formal roles for robust frontline support for everyone using the analytical platform. Additional, ongoing education and training will reinforce the day-to-practices necessary to realize the maximum value from technology investments and the desired improvement in care outcomes for attributed patient populations.