Effective Training of Health Plan and Provider Staff Critical to Implementation Success
April 13, 2017
Patricia Ingerick, MBA, MSHS, Senior Director, Transformation Services
The reason most health plans choose our Theon® advanced analytics platform is to more effectively and efficiently manage their value-based partnerships with providers. As I’m certain you know, quality, cost and member satisfaction goals are the heart of value-based relationships, and that means they are much more comprehensive and data-dependent than traditional fee-for-service ones. The Theon® tool greatly simplifies value-based contract performance management, making it easier for the health plan and participating providers to determine where they stand at any moment during the contract year, diagnose problems and take corrective action.
As my colleague Tom Murray wrote, our implementation best practices – the ones that are critical to our ‘quick start,’ 12-week implementation – include leveraging “Geneia’s training resources for health plan staff and value-based provider partners and their office staffs, including scenario-based training specific to business requirements.” Equally important, “people train within the Theon® environment rather than relying exclusively on paper and digital manuals.”
That’s where I come in.
The Geneia Institute
I am the lead educator for The Geneia Institute and manage a team responsible for training our clients in how to maximize their investment in the Theon® platform. Critical to our ability to do this is the fact that my team and I are intimately familiar with the Theon® tool as well as the healthcare system, especially the changes necessitated by the industry’s evolution to value-based care. In fact, in addition to providing Theon® platform training, The Geneia Institute creates and delivers a variety of educational courses for all organizational levels around population health topics. Among our offerings for clinicians are risk management, behavioral change and motivational learning via eLearning, 10-minute micro-learning and extensive 40-hour courses.
Each training is unique as we structure the sessions to mirror the client’s reasons for licensing the Theon® tool. That said, there are topics we typically cover, including understanding your population of members and provider performance analysis. Much more than sessions on how to access reports, we help our clients learn to use the information in the Theon® platform to meet their specific cost, quality and member satisfaction goals.
Health plans and their value-based provider partners benefit from a better understanding of their member populations, including demographics, risk status and risk status trend, and how they have – or have not – been interacting with the healthcare system.
Encouraging Theon® Platform Exploration
One of the first things we show is the Theon® solution homepage, which has a wealth of information in the population measures, and we invite people to click around and explore. If you’ve ever participated in software training, you know how rare it is to encourage exploration, but at Geneia, we know that’s how adults learn best.
The Theon® homepage screenshot below shows there are nearly 4,000 patients in this provider panel with 10 currently admitted to the hospital, eight discharged in the last 10 days and a readmission percentage of 7.67 percent, all of whom are at higher risk for a hospital readmission. Nearly 19 percent – 738 of the 3,980 patients – have not been seen by their primary care provider in the past 12 months, a group of individuals well worth investigating because they potentially represent members with rising risk and/or risk for a high-cost, chronic condition.
We also typically spend time helping our clients understand how to use the Theon® solution to identify subpopulations with potentially higher medical needs. One such subpopulation is members who had a hospitalization in the past 30 days, are currently admitted to the hospital and have High Condition Risk (see screenshot below). At this point, we show our clients how to review the providers attributed to these patients to initiate appropriate levels of engagement for these high-risk patients. Health plans and their value-based provider partners also may want to monitor engagement levels for these high-risk members, and that too can be easily accomplished with the Theon® tool.
As a lifelong learner and educator, nothing makes me happier than guiding our clients to learn the skills to enable them to use – self-serve and on-demand - the Theon® platform to achieve this year’s quality, cost and member satisfaction goals as well as next year’s and the ones that are being considered for the following year’s contract.