Shifting Sands of Healthcare

Our world of healthcare is changing rapidly and converging to a new (and hopefully better) paradigm. We are seeing the shifting sands of healthcare going from fee-for-service to value-based services. More precisely, we are about to put new demands on healthcare that focus on processes that reduce cost. What are the new initiatives that will rise up over the horizon and help this effort?

First, let’s look at what the experts are saying: A recent survey from KPMG showed that healthcare executives saw cost as the biggest challenge in implementing population health management programs1. That same survey of nearly 300 executives showed that the leaders expected the following benefits from population health programs2:

– 36 percent of respondents said preventive care will be the biggest benefit of population health management.
– 23 percent anticipate the biggest benefit to be developing evidence-based clinical strategies to improve efficiency.
– 21 percent said the biggest benefit will be managing chronic disease.
– 19 percent said it will be developing strategies to improve the quality of care.

It’s interesting to note that a large percentage of the executives focused on “preventive care” as the biggest benefit of population health management. This new model fits perfectly with CMS’s strategy of implementing “Annual Wellness Visits” to Medicare-eligible recipients every year.

Of the same survey of executives, they uniformly showed concerns in implementing population health programs3:

– 42 percent thought cost was the biggest challenge.
– 28 percent found transitioning staff and physicians to new population health programs to be the biggest challenge.
– 19 percent said interoperability of their programs with other providers posed the greatest challenge.
– 14 percent said coming to terms with new payer relationships was the biggest challenge.

A common theme from this survey seems to point to the recognition by the executives that in order to flow with the “shifting sands” of healthcare, the challenges to be overcome clearly are focused on implementing cost-effective preventive health strategies and making the shift as painless as possible for the doctors and the staff. This latter part could be difficult because for years physicians have been encouraged to practice their own unique “art of medicine” to heal patients; now they are being told that they must follow “evidence-based care plans” to optimize quality and reduce cost. This could be the hardest shift in the sand.

WellTrackONE has responded to the challenges by putting forth an easy and cost-effective preventive health system focused around the Annual Wellness Visit. Our systematic approach to wellness gives forth risk predictive values uniformly across a patient population in a non-invasive way. We have also further addressed the issue by producing the WellTrackONE Reportal System to give healthcare executives fingertip access to HCC risk adjustment codes, population health trends and outcomes information – all within the confines of the Annual Wellness Visit system. And finally, we’ve helped the transition by a scheduled launch of over 50 standardized care plans based on evidence-based medical standards. These care plans will be integrated into the WellTrackONE Clinical Triggers so care teams can see the pathways recommended for their patients who have chronic illnesses.

The sands of healthcare continue to shift, but at least we are getting a clearer picture of how they will settle out and more importantly, what the needs are going to be to help physicians transition into the new world of healthcare. The shift from fee-for-service to quality-based medicine is underway. Now we need to help physicians with new tools that are easy to use and make sense.

WellTrackONE has responded to the challenge.

References:

1. Article from Becker’s Hospital Review written by Emily Rappleye, January 15, 2015.
2. Same
3. Same

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