Thursday, March 28, 2024

Remote patient monitoring: Benefits and challenges of implementation

For years, my mother-in-law was cared for in the comfort of her own home. That’s when I witnessed first-hand (and in frustration) the myriad challenges that remote patient monitoring (RPM) could have easily remedied.

I also watched an 80-year-old with a 30-year history of diabetes no longer need insulin after managing her own A1C levels simply with the help of a continuous glucose monitor (CGM). So I guess you can teach an old dog new tricks after all!

With the rapid advances in RPM, health care providers are coming to the same conclusions for themselves and their patients. They’re finding that this technology offers improvements in the forms of better patient outcomes, lower costs, and the ability to deliver more personalized and patient-centric care, all while reducing workloads.

Thankfully, the health care industry at large is also catching onto these critical benefits. In fact, with the help of large-scale investments that have been steadily rolling in, the RPM market is slated to have a compound annual growth rate of 3.3% over the next decade.

Of course, as with any developing technology, RPM comes with its own unique set of obstacles, from reimbursement and billing challenges to technical glitches and patient adherence. However, because of how greatly the benefits outweigh the limitations, we can’t afford not to confront these issues head-on.


What health care challenges can RPM solve?


Until recently, in order to diagnose patients or gain an in-depth understanding of their health status, medical professionals had to rely on testing (often of the stand-alone variety) or self-reported medical history. The problem is that the accuracy of these methods is dependent on a patient’s memory and on the state of their health at the time of testing.

Now, with a standard consumer wearable such as a smartwatch, used in conjunction with scientifically validated mobile app platforms, patients’ vital signs (such as heart rate, blood pressure, and ECGs) can be collected and sent to health care providers in real time. This allows clinicians to observe a patient’s health status from afar, and to promptly suggest necessary interventions or adjust medications as needed.

This technology can also help to reduce workloads for health care providers, whose job demands have become especially demanding since the Covid-19 pandemic. While hospitals have been quite literally overflowing (specifically during the peak of the pandemic) RPM has the potential to prevent that same crisis from occurring in the future. When clinicians can observe patients’ health remotely, they can more accurately determine if hospitalization is necessary, preventing overcapacity in hospitals and unnecessary burnout in health care workers.

Providing more personalized health care and increasing patient engagement also becomes easier using RPM. With a constant inflow of real-time patient data, clinicians can, under certain circumstances, recommend relevant health care practices, prescribe medications, and make informed decisions regarding post-operative care without the need for an in-office visit. They can also prioritize their focus based on patients’ risk levels, which can be determined through their RPM platform.

In addition to more fine-tuned patient care, RPM technology helps to reduce health care costs. It does so by alerting patients and health care providers when an issue is arising or projected to occur, allowing for timely interventions that prevent otherwise costly health challenges. In the same way, remote patient monitoring helps to lower hospital readmission rates and unnecessary emergency visits, easing financial burdens.


What are the challenges in implementing RPM?


I’ve seen time and again where technological challenges present significant roadblocks for industries. They prevent businesses from applying novel innovations that would ultimately benefit them and improve their quality of care.

The same goes for implementing RPM programs. Doctors are busy, and learning any new technology can be a daunting task. Because of this, there ought to be a direct focus among tech companies on creating simple mobile applications for RPM programs.

Another challenge is that accurate RPM depends on a patient’s ability or willingness to actively participate in the program. It’s not uncommon that a patient forgets to wear or charge their device, leaving gaps in data. Or they simply may not know how to use a device or an app properly. All of which compromises the success of the RPM program.

Doctors may also find themselves overwhelmed by the vast quantities of data constantly rolling in. Raw or vague data points can be difficult, if not impossible, to interpret—especially when providers are having to remotely monitor multiple patients, in addition to their usual in-person visits.

Finally, reimbursement for RPM services can create implementation obstacles. Medicare and other insurance agencies have specific requirements for patients to be eligible for an RPM program. For instance, certain conditions, such as heart failure, diabetes, and chronic obstructive pulmonary disease may qualify for reimbursement, while others don’t. And, with this being a newly developing technology, there may not be adequate knowledge or resources readily available for health care providers to properly navigate these payer mandates.


How can tech companies encourage RPM adoption?


With technical challenges being a significant obstacle to more widespread RPM adoption, tech companies have the ability (and even the responsibility) to create platforms that are both simple and intuitive to use.

For one, RPM platforms should integrate with hospital EHRs. This will significantly improve care coordination and can decrease administrative workloads (such as tedious filing and data entry). Tech companies should also focus on offering training and support for integrating these platforms into new practices to ensure that health care providers are comfortable with the product.

Automated data analytics and reporting within the mobile platforms is another important facet to be considered. By eliminating the need interpret the data themselves, health care providers can make informed decisions based on the crunched data. This saves them time while also improving health outcomes for their patients.


RPM offers benefits for medical practices of all sizes


Because RPM helps reduce health care costs and provider workloads while improving patient engagement and health outcomes, the playing field has become more leveled. Now smaller, private medical practices can offer the same high-level services as large organizations without committing to an overwhelming investment. Smaller practices can then take on more clients without adding to their task volume, aiding their ability to remain independent.

As tech companies continue improving their platforms, and health care providers better understand the benefits of applying this technology to their practices, we’ll undoubtedly find rapid progress in the quality of global health care.


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Wednesday, March 27, 2024

Navigating revenue challenges in ypur medical practice

Today’s financial leaders in healthcare face several challenges impacting revenue, creating the need for an intuitive platform that acts as the ‘CFO whisperer’, delivering tailored recommendations based on an organization’s specific needs. The ability to confidently calculate cash and forecast net revenue is essential to ensuring effective operations management and a healthy cash flow to ultimately deliver high-quality patient care. The evolution of industry technology allows organizations to accurately forecast revenue and derive valuable insights based on historical data and contractual agreements. Armed with these insights and recommendations for increasing revenue, organizations can successfully improve satisfaction among patients, employees, and stakeholders while delivering high-quality care.


Why net revenue?


One obstacle many practices face in revenue cycle management is that gross revenue is fake. It may as well be monopoly money. Gross revenue exists only as a proxy that's used in the interim while final net revenue is determined, which can be delayed by the insurance reimbursement process and cause confusion. However, making business decisions based on a mere proxy for actual revenue is problematic as well. It’s essential to know if the revenue cycle unit is performing well, understand timing of cash inflows to make payroll or meet debt covenants, as well as many other operational demands. The process of using both historical data and contractual agreements to forecast net revenue requires a strong and accurate model that can efficiently aggregate data and produce reports that provide financial leaders with a clear understanding of the company’s revenue outlook. Using a platform that has the ability to accurately forecast revenue helps build a bridge between revenue cycle and financial leadership, enabling a more cohesive strategy for business decisions and gives a clearer understanding of financial health.


The growing necessity of net revenue forecasting


Many strategic decisions that medical practices make are time-sensitive and are directly impacted by revenue levels and activity. It has never been more critical for organizations to have the ability to reliably forecast net revenue. Today’s practices are facing many adverse market conditions, including razor-thin margins, the threat of consolidation, and rapidly changing care needs amongst aging populations. In the current state of the industry, companies no longer have the luxury of waiting a few months down the line to look back and analyze revenue to course correct for the future. Net revenue forecasting provides opportunities to increase health organizations’ margins through more granular insights that are delivered in real-time.


Why is accurate net revenue forecasting so valuable?


According to the AHA, the median health system cash reserves fell 28% in 2022, which can be a symptom of inaccurate net revenue forecasting. When done well, forecasting delivers reliable and repeatable results that yield fine-grain measurements. Utilizing technology that can provide this creates healthier cash reserves with less time spent on manual entry, which is essential at a time when it can take practices over seven business days to complete month-end financial activities. With many teams facing staffing shortages and working to overcome limited bandwidth, it’s extremely valuable to have a precise, repeatable, and efficient process that improves operations overall.

Accurate forecasting not only helps solve cash reserve shortages, but also solvency issues, liquidity, and can prevent payroll delays, in turn limiting staff dissatisfaction. It also translates to more explainable and accurate physician compensation. Most organizations utilize net revenue forecasting as a part of the equation for activities critical to the health of operations and care delivery, so being precise is paramount to stability and satisfaction across the board.Using an intuitive and comprehensive platform for managing financial activities can produce these accurate insights and provide organizations with financial X-Ray vision.

The other key component to improving financial health, which works in tandem with precise forecasting, is the delivery of valuable insights to allow financial leaders to identify the root cause of any shortages.

To pinpoint the source of revenue shortages, information like service, location, procedure, payer contract, and other confounding factors need to be easily accessible to view the variances causing drops. Having direct access to this data and a clear view of the information is the most efficient way to directly increase revenue, and eliminate excessive time spent digging through spreadsheets or coordinating with other teams for access.No matter what an organization’s financial goals are, whether it’s auditing the past or forecasting the future, using a holistic platform that harnesses the power of historical data and contracted rates can put users on a level “paying field”.

The challenges faced by financial leaders in healthcare underscore the critical importance of accurate net revenue forecasting. In the face of rapidly changing care needs, evolving technology provides the means to not only forecast revenue accurately but also derive valuable insights into where there is room for improvement. This shift towards more sophisticated forecasting methods not only enhances financial health but also empowers healthcare organizations to make informed, strategic decisions that ultimately lead to the delivery of high-quality patient care. As a result, the growing necessity of net revenue forecasting in healthcare is a cornerstone of financial stability, operational efficiency, and the provision of optimal care in today's dynamic healthcare landscape.


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Tuesday, March 26, 2024

The role of in-home services in primary care

It's not hard to see which way the winds are blowing when it comes to in-home primary care programs. From Walgreens increasing its investment in VillageMD to CVS announcing its planned $10.6 billion acquisition of Oak Street Health, there are massive moves being made by some of the industry’s largest players because they see the potential of this sector. Even Amazon is joining in with its purchase of One Medical.

We are seeing heightened interest as we look at our business as well. As a testament to the strong demand for in-home advanced primary care services, Emcara Health will see roughly 40% growth in 2023. This demand comes not only from our traditional health plan clients, but also from health systems who are trying to solve problems like addressing the needs of underserved patients through community-based outreach.

What’s driving this trend? The short answer is: pretty much everything. Our population is getting older and sicker every year. We are experiencing a dramatic shortage of primary care professionals and high rates of burnout among those who continue to care for patients. Rural hospitals are closing at an alarming rate, creating care deserts for many with serious health concerns. Meanwhile, health care costs continue to escalate at the same time many providers are struggling to stay afloat.

This confluence of factors has led us to an explosion in services aimed at bringing care to the patient’s home. These services offer the ability to extend the impact of providers, drive improved cost and clinical outcomes for health plans and most importantly, create access to highly coordinated, high-quality health care for Americans who are vulnerable and underserved.

Unfortunately, any time this type of rapid growth occurs in a sector of health care, things get complicated and confusing. There are many different types of home care offerings, and not all of them are created equally. Not all of them will effectively integrate with the existing system. Not all of them will lead to positive changes for patients.

The perfect example of this is the recent proliferation of point solutions--technology designed to address a specific problem--headed to the home. Independently, these condition-specific approaches have merit, but picture an older individual with multiple health concerns. Depending on this person’s needs, there may be numerous different providers coming to their home for services such as diabetes support, chronic kidney disease treatment, physical therapy and so on.

These point solutions further fragment an already splintered system, making care coordination nearly impossible. But even if health care organizations think holistically in terms of the partners and solutions they choose, it’s not enough to ensure success. As an industry, we must play and pay differently or risk watching a much-needed service crash and burn.


We have to play differently


This means more collaboration among health plans and providers and deeper, more coordinated care. It means that all stakeholders will have to get comfortable with innovation and with partnering in a more profound way on behalf of the people they serve. Health plans must provide more support to help providers be successful. Providers need to embrace new resources and re-imagine how they deliver care, particularly when care is needed beyond their four walls.

An advanced approach to in-home primary care requires collaboration and coordination. It requires better sharing and leveraging of data, and that we broaden our view of the patient and holistically address their needs as we engage them in the home. It means supporting patients in an integrated, highly coordinated way while managing issues such as behavioral health, medication management and social determinants of health in addition to acute and chronic medical concerns.

Accomplishing all this requires access to a multidisciplinary care team that includes clinical staff, behavioral health specialists and community health workers. In many cases, health plans and providers need to bolster internal resources by partnering for this type of team effort, which again underscores the growth our company has seen in recent years.


We also have to pay differently


This means transitioning from traditional fee-for-service payments to a value-based approach. We need to see more focus on value-based payment models in the primary care setting, particularly in support of high-risk patients with complex medical, behavioral and social needs. Even with access to high-performing medical groups, many of these patients will still fall through the cracks.

Augmenting a provider network with in-home services for vulnerable and underserved individuals creates another layer with which to cover care gaps. When you wrap a value-based model around this support to align incentives, both community and in-home care providers are rewarded for delivering optimal patient outcomes. Increasingly, it seems obvious that value-based models are the path forward, particularly for advanced primary care efforts.

Wind is a powerful force, and if harnessed correctly it can carry you to new heights. But if aimed in the wrong direction, it can level your house. We are reaching a pivotal point in the delivery of in-home primary care that can usher in an entirely way to support millions of Americans in need. It’s up to all of us as an industry to ensure we make the most of this opportunity.


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