If you’re exploring patient outreach strategies to help reduce no-shows in your physician practices, click here to learn more.
The reality for medical practices is constantly changing. Independent physicians are increasingly under financial strain due to the shifting reimbursement and regulatory landscape and seeing their margins shrink. At the same time, the migration of care from acute to ambulatory environments has prompted health systems, hospitals and large medical groups to acquire and consolidate clinics to expand their physician networks.
This new reality begs the question – how do you transform a collection of disparate practices into a high performing medical group?
While many practice leaders prefer a “hands-off” management approach, it can create future challenges because it fails to capture the benefits of running a truly integrated medical group. Such organizations are able to offer improved access, a stronger referral network, operational economies of scale, and ultimately, better care quality and outcomes.
To unlock the benefits of high performing medical groups, operations leadership must find new ways to optimize profitability and productivity across their practices. There are a number of scalable tactics that can help accomplish this, including: reducing no-shows, boosting volume through prevention, and automating processes.
While it might seem like a no-brainer, reducing no-shows is beneficial to your patients, providers and staff, and practices. When left unchecked, no-shows can have wide-ranging negative effects with potentially long-term consequences. That’s why high performing medical groups implement organization-wide tactics, such as appointment reminders, to proactively mitigate no-shows before they become a problem.
To help your leadership understand the value of a no-show reduction program, it’s important to convey the true costs of missed appointments. The low-hanging fruit is the short-term financial impact. Simply put, when your patients don’t show up for their appointments, your practices are missing out on revenue. In addition, higher-wage employees, such as physicians and advanced clinical practitioners (ACPs), are seeing fewer patients and are not utilized to their fullest potential.
Digging deeper, it’s also important to understand the extent to which no-shows compromise access and outcomes. When patients miss their scheduled appointments, it diminishes a practice’s ability to serve patients with more urgent needs because it reduces its effective capacity. When such patients are not receiving the care they require in a timely fashion, it increases the likelihood of negative outcomes and decreased payments-for-value.
Boosting Volume Through Prevention
Preventive health outreach is another tool in the high performing medical group’s toolkit that can drive growth. While most, if not all, physicians understand the value of prevention, not enough medical groups are making a concerted effort to promote it amongst their patient populations. The reality is staff are overworked and in many cases can only focus on the problems at hand during patient visits. While population health initiatives have gained momentum in the physician community in recent years, there is still not enough focus dedicated to long-term risk management, which is essential to improving outcomes, lowering costs, and maximizing payments.
High performing medical groups use a number of tactics to encourage prevention and in turn, improve physician performance. One approach is to leverage electronic medical records (EMRs) or patient registries to identify gaps in care and use automated reminders to proactively seek to close them. Practices can task ACPs to carry out wellness examinations, which allows such staff to work at the top of their licenses while freeing up physicians to focus on patients requiring more complex care. Another tactic is to target patient cohorts that are due for cancer screenings and vaccinations, and get them in the door to complete them.
Keeping patients engaged with their health decreases the likelihood of preventable negative outcomes as well as chronic disease management in the future. This can translate into measurable quality and experience improvements, which not only have the potential to unlock financial incentives, but bolster patient satisfaction, volume, revenue, and loyalty.
Like most industries, healthcare is finding ways to incorporate automation into everyday tasks and processes. Medical practices, in particular, stand to benefit from automated clinical and operational workflows because it helps to address a number of contemporary challenges, including heightened patient expectations, increased prevalence of provider burnout, and high operating expenses.
The benefits of automation in the practice setting are numerous. Firstly, it can relieve staff of manually intensive activities, such as front office tasks and patient outreach. Such labor savings can elevate non-physician clinical employees into higher functioning roles, enabling them to focus more on patient care. Second, it offers a higher level of consistency and quality because automation tools are not subject to human error and exhaustion.
Use of information technology, such as EMRs, clinical decision support systems, and automated preventive reminders, can provide a more consistent basis of care and quite literally help save lives. As an added benefit, automation technology equips providers with actionable data that can be used to inform practice improvement decisions. Although any patient or provider would prefer the personal touch, as the reality of healthcare changes, finding efficiencies will help ensure better outcomes and experiences for patients and staff members.
Upward and Onward
The tactics presented in this article are three among many that can boost the performance and productivity of your medical group. To remain competitive, it’s imperative that you continually challenge the status quo and seek to adopt standardization measures across your physician network.
We invite you to check out the resources below for additional information that can assist you on your journey to becoming a high performing medical group:
The healthcare industry has faced various changes over the past few years. In the center of these changes is a shift from volume to value-based care. As this shift takes place, there is a rising focus on innovative care delivery models such as the Patient-Centered Medical Home (PCMH). Under the PCMH model, a patient’s primary care physician coordinates treatment to ensure he or she receives proper care when and where they need it. In order to earn various incentives under this program, physician practices look to become PCMH-recognized.
The National Committee for Quality Assurance’s (NCQA) Patient-Centered Medical Home (PCMH) recognition program is one of the most well-known, requiring practices to meet a combination of core and elective criteria to become NCQA PCMH-recognized. Having earned NCQA PCMH Prevalidation, CipherHealth’s patient engagement solutions are pre-validated by NCQA for practice credit towards nine criteria towards a practice’s PCMH evaluation.
Among the core auto-credit criteria that CipherHealth is prevalidated for is KM12: Proactive Reminders. This criteria falls under the “Knowing and Managing your Patients” concept area, which focuses on practices’ use of data to conduct population health management. This requirement encourages increased access to patients regarding appointments, as well as for practices to proactively identify populations of patients and remind them of needed care based on patient information, clinical data, health assessments, and evidence-based guidelines.
An example of this program would include practices identifying an outreach cohort for preventive screenings with an applied focus of patients that are lacking those services. For example, patients with an overdue mammogram or colorectal cancer screening.
Engage with patients via phone call, text, or email to remind them of needed care, such as upcoming immunizations, wellness appointments, or preventive screenings to meet these requirements.
Big data and care coordination are improving population health and lowering cost. To learn how CipherHealth solutions can help your organization meet criteria KM12 and a host of other criteria, contact us today.
Healthcare providers across the continuum have a considerable stake in understanding the reasons for hospital readmissions. When a patient has been readmitted, the initial concern is that someone failed to do their job. However, a hospitalization does not necessarily reflect poor quality of care or even that a mistake was made.
With hospitalization rates being a key quality metric for many home health agencies, it is imperative for agencies to proactively find ways to improve outcomes with scalable processes that engage the patient in their care. However, first, they must understand why their patients are going back to the hospital to truly make an impact on their rates.
Rehospitalizations can be a challenge for any home health agency. Therefore organizations must perform a root cause analysis and take steps towards improvement.
Three factors that may be influencing your hospitalization rates include language barriers, care environment, and medication management. Diving deeper into these three challenges can help home health agencies understand how to address the unique needs of their patient census and improve outcomes:
Miscommunication in the healthcare industry can be life-threatening. If a patient has a difficult time understanding their providers due to a language or literacy barrier, they will find it equally as challenging to understand care instructions. To address this challenge, home health staff should employ things like the teach-back method to ensure patient comprehension.
Home health agencies are a critical part of the care continuum and play an essential role in reducing costs by preventing rehospitalizations. By understanding the various factors that can lead to rehospitalizations, agencies are well-positioned to be a worthwhile partner for their hospital referral partners by improving patient outcomes and reducing readmissions.
To perform a root cause analysis of readmission rates, agencies can perform regular chart reviews, perform proactive outreach, or perform in-home surveys to identify the leading causes of readmissions for their agency’s census. While there are many strategies to effectively reduce home health readmission rates, finding the reasons why they happen in the first place will be the key to success.
– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –
If you are interested in learning more about reducing readmissions, download this case study that explores how a Pennsylvania-based home health agency reduced their readmission rate by 16.3%.
Consumer demand is shaking up traditional industries more than ever. From Lyft to Airbnb, expectations for fast, convenient, and affordable options are allowing industry newcomers to grow and obtain significant market share across various market segments.
Healthcare is no different and arguably has more at stake in meeting patient demand, as financial incentives are tied to patient satisfaction and outcomes. Patients want the same affordable, easily accessible, and personalized options they have come to enjoy in other facets of their lives. However, the healthcare industry is struggling to keep up with these growing demands. According to a recent study, nurses spend 73% of their day on documentation and administrative tasks. Instead of conducting repetitive tasks with little value for patients, nurses can drive better outcomes by dedicating their specialized expertise to patient care. Understanding this, how can healthcare leaders address this challenge head-on by empowering their nursing staff to work at the top of their licenses?
Why Front-Line Healthcare Providers Need Workflow Automation
With growing documentation requirements, the administrative burden on nurses has ballooned over the last decade. Today’s nursing school graduates abide by this rule: “If it wasn’t charted, it didn’t happen.” By performing repetitive, potentially duplicative work, nurses must allocate significant time to tasks removed from direct care, leading to higher burnout rates.
Since provider engagement is an important strategy to drive better patient outcomes, addressing these challenges means more than hiring additional staff – requiring leaders to find smart ways of scaling processes and maximizing the resources at hand. By bringing automation into everyday processes, nurses can focus their expertise and specialized skillsets on care delivery.
How Automation Optimizes Experiences
To identify where automation technology can be valuable, it is essential to first understand what it means to automate. According to the International Society of Automation, automation is the creation and application of technology to monitor and control the production and delivery of products. Automation has been used in various industries to meet changing consumer demands. For example, retail companies understood they needed to tailor online shopping experiences to an individual shopper’s preferences. Personal shoppers enhance the in-store experience by recommending clothing items according to the client’s taste and style – creating an experience tailored to the individual. To create a personalized shopping experience for online shoppers, retail companies leverage automated technology that recommends items based on past purchases and recent page views. The success of online shopping may be attributed to the personalized experiences and instant gratification consumers receive. Similarly, automated technology can accelerate innovation in healthcare delivery by streamlining repetitive processes such that interactions can be tailored to the individual.
By leveraging automation in clinical workflows, hospitals and health systems can more effectively engage with patients without adding additional administrative burdens for front-line providers. Clinical workflows can be automated with enhanced clinical decision support, care management task assignment, appointment reminders, and post-discharge follow up outreach.
In the example of post-discharge follow up, hospitals can automate the initial outreach call or text to assess recovery status for all patients within a target population. The automated outreach triages those individuals who indicate concerns, empowering clinicians to engage patients with targeted and meaningful information. This contrasts sharply with traditional outreach methods, in which nurses become increasingly frustrated with unsuccessful attempts to reach patients with manual outreach processes.
Automated workflows ensure that staff not only have more meaningful conversations, but patients are connected to the resources they need more quickly. This reduces the likelihood of adverse events, such as avoidable readmissions.
How Workflow Automation is Accelerating the Healthcare of Tomorrow
By implementing the right technology that reduces repetitive work, hospitals and health systems will experience healthcare’s Quadruple Aim of improved patient outcomes, enhanced patient experiences, increased staff satisfaction, and lowered cost of care. To maximize labor efficiency ROI, leading healthcare organizations are leveraging automated technology to reallocate valuable nursing resources to direct patient care. When providers work at the top of their licenses, healthcare organizations are better equipped to face the growing challenges presented by the ongoing evolution of the industry.
To learn more about how automation is changing the healthcare industry, we invite you to check out these resources:
According to a recent Health Affairs study, only eight percent of adults over the age of 35 in the U.S. are receiving all recommended high-priority preventive health services. This finding highlights how much room there is for improvement when it comes to vaccinating against and screening for preventable diseases. It also presents physician practices an opportunity to encourage patients to become more engaged with their health through prevention.
In order to help patients take a more proactive approach to their health, it’s important that providers across the continuum make prevention strategies a core component of their care delivery. Physicians at the practice level are in a unique position to take a leading role in this effort.
Preventive Health is a Win-Win for Patients and Practices
In recent years, the shift toward value-based care has underscored the importance of preventive health. By moving away from fee-for-service models, value-based care has the potential to significantly reduce healthcare costs and produce better outcomes. The amount that Americans spend annually on the treatment of people with preventable chronic diseases is staggering, and preventive health is a cost-effective strategy to improve outcomes in at-risk patients and lower healthcare costs for everyone in the system.
While practices may need to dedicate additional resources to effectively implement and administer preventive health programs, the long-term benefits outweigh the costs.
Firstly, providers that spend more time delivering preventive care are likely to spend less time on chronic disease management. This translates into quality and patient engagement improvements, which not only have the potential to unlock financial incentives, but boost patient satisfaction measures. Second, preventive health visits can drive patient volume. Prevention programs can help providers generate new revenue while simultaneously facilitate the transition to value-based care.
Once Your Patient is in the Exam Room, Seize the Moment
Physician practices, especially primary care providers, are on the front lines of healthcare. These providers are oftentimes the first touchpoint on the patient journey, whether it’s for treatment of specific ailments, wellness visits, or chronic care management. Physicians can use these opportunities to verify that patients are up-to-date with their immunizations and other preventive health services, regardless of the reason they made the appointment in the first place. This is also good practice because there may be prolonged gaps in care for select patients after their last scheduled appointment.
Physicians already performing preventive services for patients can also play a role in promoting additional preventive measures. Radiology recently published a study that found that female Medicare recipients who undergo mammography are much more likely to utilize other types of preventive health services, such as cervical cancer screening, osteoporosis testing, and influenza vaccination.
The findings also suggest that once patients are in the door for breast cancer screening, physicians have an opportunity to educate them about other preventive measures. Applying this same logic, specialists such as urologists and gastroenterologists, who regularly screen for diseases like prostate and colorectal cancer, respectively, can help increase awareness of other types of preventive services.
Technology Helps Practices Work Smarter, Not Harder
Providers can leverage technology as well to augment preventive health efforts in their practices. Electronic health records or EHRs offer a range of capabilities that facilitate action on behalf of both the provider and patient. Available technologies include vaccination alerts for staff during point-of-care, to real-time analytics to measure prevention program performance, and educational resources to reminders within the patient portal.
Automated preventive outreach can also be a powerful tool in the practice setting. Preventive outreach programs enable providers to harness multiple methods of communication to reach target patient populations. By automating educational messaging and appointment reminders, practices can better engage patients, optimize staff workflows, and capture valuable patient data that helps to inform and enhance future population health initiatives.
Given how much improvement is needed, a system-level, multidisciplinary effort will be required to ensure that patients are receiving the full extent of recommended preventive health services. While no single provider can address the issue alone, practices can make incremental progress in improving population health by considering cost-effective strategies to promote preventive healthcare.
To learn more about how proactive outreach can support your practice’s preventive and population health initiatives, we invite you to check out these resources:
Colorectal cancer (CRC) is the fourth most commonly diagnosed type of cancer among young adults in America. After results of an analysis from American Cancer Society (ACS) researchers unveiled an increase of CRC cases in younger adults, the ACS updated the CRC screening guidelines.
The updated guidelines provide guidance to young adults who may be at risk for CRC, clinicians who refer patients for CRC screenings, and healthcare systems to establish best practices for awareness, early detection, and prevention.
The new guidelines recommend the following:
Updated guidelines also indicate that there are six screening options, ranging from noninvasive stool tests to visual exams like colonoscopy, depending on the preference of the patient and availability of the test.
How Should Gastroenterology Practices Address Updated Guidelines?
Gastroenterology practices must be prepared to perform additional outreach to patients that qualify for CRC screenings. Although this can be a resource-intensive task, automated outreach can help increase staff efficiency. By automating the outreach process, staff hours are spent efficiently while patients are encouraged to schedule visits and screenings.
Early detection, prompt treatment, and continuous care can reduce the severity and risk of complications from CRC. However, the first step is getting your patients in to receive a screening. Outreach to patients doesn’t have to be a tedious and costly task. Leverage technology to empower staff to scale meaningful patient engagement to proactively detect CRC.
The key for addressing guidelines is identifying and engaging the patients eligible under these new guidelines. The most effective screening outreach programs will be personalized by patient language, communication method, and area code.
CipherHealth’s automated outreach solution seamlessly integrates with your registry to identify and reach out to eligible patients. Customized scripts and robust reporting allow for organizations to proactively identify and engage patients to drive improved outcomes. With this solution, your practices removes the challenges of having staff sort through patient registries to identify those who are due for screenings and manually having to reach out, saving countless hours on repetitive administrative tasks.
If you are interested in learning more about how to proactively engage your patients, access these free resources:
This blog post was written by CipherHealth’s Account Executive of Ambulatory Services, Brittany Herrera.
The home health agency industry is steadily going through a whirlwind of changes. Operating margins are becoming tighter and agencies are beginning to depend more heavily on reimbursements. In order to maximize reimbursements, agencies should closely examine workflows and strategize how to become more efficient and improve productivity.
The standard business model for a home health agency typically includes a large staff that mostly work remotely. With this in mind, you can easily understand the challenges and obstacles missed visits pose. If a patient misses a scheduled visit, staff time and resources are automatically lost.
Missed visits result in a lose-lose situation for both providers and patients. When a patient misses a visit, your agency’s workflows are disturbed and more time is spent on rescheduling. Missed visits can also result in higher costs of care delivery, while staff and equipment go underutilized. Most importantly, missed visits negatively affect the clinical outcomes of your patients and increase the possibility of complications and hospital readmissions.
Reducing Missed Visits with Automated Outreach
Although many of these reasons are unavoidable, patients forgetting about their scheduled appointments is easily remedied. By providing frequent reminders to patients about their upcoming visit, you ensure their appointment is top of mind and they are prepared. The challenge, however, is that agencies don’t always have the resources to manually call every patient and remind them of their scheduled visits. This is where technology becomes a great asset to both your patients and your staff members.
CipherHealth’s automated outreach technology works to reduce the occurrence of missed appointments by reminding patients of upcoming visits. CipherHealth’s home health visit reminders serve as an easy and cost-effective solution to remind, confirm and if need be, reschedule home visits. Not only does this work to curb the incidence of missed appointments, it is also essential in promoting effective agency-patient interaction and in extension improving the overall patient experience.
To learn more about CipherHealth’s visit reminder solution, request a free demo today.
This blog post was written by CipherHealth’s VP of Post-Acute Business Development, Gina Gambaro.
We’re excited to announce that CipherHealth has achieved PCMH (Patient-Centered Medical Home) Prevalidation from the National Committee for Quality Assurance (NCQA) for NCQA’s PCMH 2017 Program. CipherHealth’s prevalidation offers physician practices a streamlined pathway towards becoming PCMH Recognized.
PCMH Prevalidation is designed to help organizations identify health IT solutions that alleviate aspects of meeting NCQA PCMH Program requirements. The PCMH model is vital to the healthcare continuum, as it encourages improved quality of care and enhanced provider-patient relationships. Also, the model encourages organizations to embrace technology by introducing incentives for adoption.
When practices achieve NCQA PCMH recognition, not only do these organizations reap the benefits of increasing their bottom lines but, it also positively affects their patients. Studies show that when practices are NCQA PCMH prevalidated, quality of care is improved and the patient experience is enhanced, all while reducing cost.
CipherHealth’s patient engagement solutions were able to demonstrate the capability to meet the program’s essential elements, which exemplify characteristics of the medical home. Attaining NCQA PCMH Prevalidation directly aligns with CipherHealth’s mission to “improve patient outcomes and experiences through enhanced communication and care team coordination”.
CipherHealth’s automated outreach solution, care management platform, and point of care survey application are prevalidated by the NCQA for autocredit for five criteria towards a practice’s PCMH evaluation. CipherHealth also received supporting designations for four other criteria in the PCMH 2017 Standards.
We are honored to receive this designation from the NCQA and look forward to helping physician practices achieve NCQA PCMH recognition. By providing technology that helps organizations create the patient-focused, coordinated care infrastructure required of NCQA PCMHs, CipherHealth is assisting organizations in an important transformation in healthcare. Patient-centered medical homes are the future of healthcare delivery, and CipherHealth technology is helping organizations get there.
For more information about how CipherHealth technology can help your organization achieve NCQA PCMH recognition, contact us today.
Since the Centers for Medicare & Medicaid Services (CMS) began reducing Medicare payments to providers for hospital readmissions within 30 days after discharge, patient readmissions have declined nationally. Across the care continuum, providers are working together to improve patient outcomes. As a result of changing regulations, Home Healthcare Agencies (HHAs) are looking for cost-effective ways to reduce preventable readmissions and prove themselves to be valuable to referral sources.
There are many strategies to reduce readmissions. From remote monitoring to more frequent visits, HHAs need reliable and scalable processes for keeping patients healthy and out of the hospital.
To effectively address patient and organizational needs, take into consideration these five strategies to improve patient outcomes and reduce hospital readmissions:
Changes to the healthcare setting increases pressure on providers to improve quality of care and reduce readmissions. For hospital referral sources hoping to avoid monetary penalties, HHAs must prove they can keep patients from returning to the hospital. By reducing readmissions, HHAs can not only position their agency as a preferred vendor to hospital referral sources but, improve HH- CAHPS scores.
To learn more about how CipherHealth technologies can lower your agency’s readmission rate, visit our website.