As more and more small and medium-sized hospitals prepare to take on risk in value-based care arrangements with health plans, the need for strategically designed tools to enable hospitals to be successful in such arrangements steadily increases. Myriad population health solutions saturate the health IT market today; however, most are intended for use at the enterprise health system level and are far too unwieldy for small, independent hospitals to implement, adopt and derive any meaningful benefit. Hospitals stand a higher chance of positioning themselves for value-based care success by implementing their own tools that can leverage their existing data sources for better visibility into areas such as financial performance, utilization and quality performance.
1. Find a solution that doesn’t cannibalize existing electronic health record (EHR) and IT investments – many solutions in the market today boast the potential of becoming your single population health solution; however, many hospitals are already well-established on existing EHR solutions and simply need easily digestible reports and insights, not another system in which to enter data. Your reporting solution should leverage existing investments, not attempt to replace them.
2. Lighter weight solutions require fewer resources – a widely known barrier for many hospitals in successfully adopting a population health platform is a lack of resources to support the implementation and ongoing maintenance of that platform. A lightweight, intuitive solution requires minimal staffing to operate and doesn’t require a highly specialized skillset.
3. Visualize where you are today – understanding your baseline is an important foundational step in improving in the areas of revenue, utilization and quality performance, as well as prepare your organization for risk-based contracts with health plans. Your baseline will serve as an important point of comparison as you begin taking measures to improve performance and participate in value-based care arrangements.
4. Stratify your population into risk categories to make the most impactful interventions – looking at an entire population and understanding where to begin to improve the health of that population is overwhelming. By implementing a reporting solution with the analytical horsepower to stratify your population into risk categories, you will be better positioned to focus on those individuals who may be moving from costly categories to an even costlier one.
5. Understand inpatient admissions and corresponding diagnoses to deliver efficient, cost-effective care – with the increasing attention and financial penalties associated with readmissions in recent years, gaining insight into your hospital’s inpatient admissions patterns is crucial. Understanding not only your readmission rate, but what’s driving readmissions, is critical in enabling your hospital to reduce readmissions and avoid financial penalty. By understanding the primary drivers of your readmissions, you are better prepared to educate and support patients by promoting alternative services within your hospital.
6. Identify opportunities to introduce new services, and/or expand accessibility to existing services – by understanding current utilization patterns and areas of leakage, you will be better positioned to identify potential opportunities to introduce new services within your hospital. Sometimes it’s even as simple as increasing accessibility to existing services, but insight is the key ingredient to make this determination.
7. Decrease leakage by driving patients to existing community services – sometimes leakage is simply due to patients not knowing certain services are available through your hospital or satellite locations. By identifying the areas patients are receiving care outside of your hospital, you can effectively promote available services to the community you serve.
8. Choose a solution with predictive analytics – set up your organization for value-based care success by selecting a solution fueled by predictive analytics. Your organization will be better positioned to achieve proactive versus reactive approaches to population health management by anticipating the needs of your population through factors such as readmission risk and inpatient stay probability.
9. Improve quality performance among employed physicians – closing gaps in care has a direct impact on driving revenue and improving patient outcomes. By understanding where your gaps are during the performance measurement period, your organization has the opportunity to manage and close those gaps before the measurement period ends. Additionally, it’s well known that physicians are resistant to successfully adopting additional systems outside of their EHRs – by implementing a reporting solution that can be accessed by non-clinical support staff, the burden is not placed on clinicians.
10. Seek outside help – to get the most value out of your reporting solution, engage the professional services of a consulting group with population health management experience. Consultants have experience working with many organizations, and know what works and what doesn’t. They can assist you in identifying the most efficient strategies to drive additional revenue, preserve existing revenue as well as improve patient outcomes and experience.
Strategically investing in an analytics and reporting solution doesn’t have to mean implementing a behemoth population health platform. The ideal solution is quick to implement, intuitive, requires minimal resources to operate, and doesn’t break the bank. It will also accommodate and scale with the hospital’s journey to value-based care readiness and participation by delivering the right insights at the right time.