Saturday, February 27, 2021

How to ensure a viable future for community-based specialty practices

Community-based specialty providers play a critical role in driving better patient outcomes by providing quality care right in the neighborhoods where patients live and work. In addition to providing quality care, they can offer cost-effective and accessible care for patients with serious and prolonged chronic conditions, such as cancer, multiple sclerosis, rheumatoid arthritis, and many other diseases. These complex, ongoing illnesses can be treated effectively in the community space near patients’ homes where they have quick and easy access to their care team and support network.


Community specialty providers deliver a wealth of benefits


Independent specialty providers play an important role in containing spiraling healthcare costs. These providers see patients regularly, enabling them to prescribe small amounts of a drug, closely monitor its effectiveness, and appropriately adjust the medication as needed, rather than providing larger quantities of a medication and then discarding after a short time if they prove ineffective.

Multiple studies show that community specialty may be more cost-effective than other sites of care. For example, a recent study found that treatment costs for breast, colorectal and lung cancer patients were significantly lower in community clinics: total costs of care per patient per month were lower across all tumor types in the community setting ($12,548 vs $20,060).1

With patients paying increased out-of-pocket costs, savings offered by community specialists are an important advantage, but there are other benefits to patients. Those with serious or chronic diseases need an entire care team to support them. A support system close to home provides the opportunity for timely care to achieve better outcomes and is less disruptive to the patient and caregiver. This is especially important for those requiring frequent treatment. Patients may also have convenient access to emerging treatments, as clinical trials draw many patients in the community setting.


Best practices for long-term viability


With the many, ever-changing challenges community specialists face, it can be difficult to stay on the path to success. To thrive in the new value-based environment, close attention must be paid to all aspects of the operation. Following are a few best practices to help ensure long-term success:


Run an efficient practice


Being administratively strong is essential for a successful practice. Physicians need to ensure they manage their revenue cycle efficiently and understand the business and financial operations of their practices. Additionally, while physicians are focused on clinical excellence, it is critical to have a highly skilled business staff to run a practice effectively in today’s complex environment.


Rely on experts for payer contracting


Payers are very sophisticated around physician reimbursement. Practices should connect with experts to understand not only the reimbursement methodology in the fee schedules but also the numerous obligations outlined in their payer agreements.


Join a group purchasing organization


While it is difficult to generalize across specialties, it may be beneficial for a practice to consider joining a group purchasing organization (GPO), especially those infusing or injecting drugs. A GPO aggregates practices together to achieve purchasing volume to negotiate better pricing from pharmaceutical manufacturers.


Utilize a drug inventory management system


Specialty practices spend a tremendous amount of money on drugs, so it is critical to employ an inventory management system to minimize losses on product that goes unused or reaches expiration. Choose a robust solution that integrates directly with electronic health records (EHRs) and ordering systems, empowering superior drug management that enables the practice to maintain lean inventory.


Don’t go it alone


With the emergence of value-based care, healthcare has become extremely complex. For the typical community-based specialty practice, trying to succeed with little help is probably not the most effective way forward. Fortunately, there is a wealth of expertise available if practices take the initiative to look for it. By connecting with their distributors, GPOs, and other groups they are working with, practices can ensure they are current with the best technology tools and consulting services. Even though today’s environment is challenging, solutions do exist. It is just a matter of leveraging existing relationships to learn about them.


References


1. https://ascopost.com/News/59474


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Friday, February 26, 2021

Creating a personalized experience for patients

2020 was a whirlwind in many ways and changed the delivery of healthcare from both the patient and physician perspectives and accelerated opportunities for collaboration. While consumerism has been a focus in the U.S. for some time, COVID-19 has placed pressure on the healthcare industry to erect a digital front door for patients (telehealth, appointment scheduling, appointment check-in, etc.). In 2021, digital and physical interactions will continue to merge. Consumers are likely to be more actively involved in their care than ever before and will expect experiences that guide them to make the best decisions for themselves and their family to meet them where they are at.


The pandemic has reinforced the idea that the best patient care can be achieved through communication, collaboration, and data sharing. As we create a new normal for how healthcare is delivered, providers need to focus on how to create a personalized experience for patients. How can you know your patient, show them that you know them and anticipate their needs?

COVID-19 is proving that everyday factors can make a big difference in a person’s current and future risks and needs, along with the type of support and preventive actions that are essential to their total wellbeing. Yet, most providers do not have access to the necessary data. Providers need to look beyond clinical information and leverage consumer data, including social determinants of health (SDoH), which are socioeconomic factors and health behaviors that drive 80% of a patient’s health outcome, to better understand their patients. SDoH data not only reveals a person’s health risks today, but it can also be leveraged to anticipate future needs. For example, our predictive data analysis shows that people who rely on public transportation are less likely to comply with preventative care and are thus at higher risk for high-cost events (i.e. emergency department visits). Domestic sedan owners are less likely to have COPD, whereas people in multi-unit dwellings are at a higher risk for COPD.


Consumers say that providers usually ask them about their physical health (i.e. diet, exercise) and emotional health, but not about SDoH factors like education or social connectedness. On top of this, nearly half (48% of people are unaware of what type of information outside of their medical history they should be sharing with their provider to get better support.



This reinforces the importance of supplementing clinical data with consumer data, so providers can get a full 360-degree view of their patient, which will arm them with the knowledge they need to create a personal and long-lasting patient relationship. Strengthening the physician-patient relationship, leads to increased patient satisfaction and trust that will help providers guide their patients towards the care they need.

The aggregation of individual level data is key to the process. “An urgent digital business priority — enhancing the customer relationship — hinges on optimized and integrated master data,” writes Ilona Hansen, Malcom Hawker, and Varun Agarwal in Gartner Research.1 Once the data is ingested, analyzed and organized, clinical, and consumer data can be combined to create a master patient index, meaning one record for each person providing the 360-degree view of the patient. This can give providers a granular understanding of the individuals in their market, as well as the population as a whole. Again, without this breadth and depth of data, it is really difficult to derive useful insights.


Here are a few tips for providers looking to improve their patient relationships:
  • Empower patients. Patients are more than willing to explore opportunities to improve their quality of care. Understanding patient wants and needs is critical as consumerism remains a focus within the healthcare space. Providers can empower their patients to take charge in their health by personalizing their healthcare experience.
  • Go beyond the four walls of the clinic. Show that you know your patient outside of the clinical setting and help them break down the barriers preventing them from achieving their highest wellbeing. For example, a patient experiencing food insecurity could be connected to a local community food bank.
  • Listen to the patient… and keep listening! Patients want to be engaged in a particular way. By using advanced analytics and consumer insights, providers can reach them with the right message at the right time via the right communication channel. This can include email, direct mail, text email or phone calls depending on individual preference.

2021 is the year to create a long-lasting relationship with patients by showing them you know them and meeting them where they are at.



References


1. Gartner: CRM Success Requires Data Management Integration. Published 19 November 2020.


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Thursday, February 25, 2021

Data-driven patient engagement strategies in preventive care

Having recognized World Cancer Day earlier this month (February 4), it’s a good time to bring attention to the fact that screenings for breast, colon, prostate, and lung cancer dropped dramatically—by 85%, 75%, 74% and 56%, respectively—at the peak of the pandemic in April 2020 compared with 2019. Experts worry this decrease will lead to higher mortality, as cancers will be diagnosed and treated at later stages.


While preventive care before the pandemic was already substantially underutilized, we’re looking at a further decline due to fear around COVID-19 and patients’ preference to avoid (or delay) non-emergency medical care.

We’ve seen this shift up close. A recent look at our data across multiple health systems found a sharp drop-off in colonoscopies in April of last year compared to the months prior. While we’ve seen some volume recover recently, others have not. Understanding the consequences of missed screenings like these – a possible delay in catching issues early, and when they’re treatable – means it’s critical to find ways to engage and educate patients about the importance of consistent, proactive, and preventive care.


Data-driven engagement strategies should align to business and patient outcome goals


When used effectively, data can play a key role in engaging patients, as it enables health systems and clinics to better understand and communicate with their unique patient community. Achieving this purposefully is critical to building a trusting and long-term relationship with the community; too much irrelevant information and a person will tune out, too little and they’ll look elsewhere for the information they seek.

Identifying and understanding the larger goals, both from a revenue and patient outcomes perspective, need to be the starting point for any data-driven patient strategy. This will ensure a tighter focus on how to achieve those goals and avoid one-off activities that distract and detract from the overall purpose, risking an inconsistent experience for patients.

For example, rather than running a one-off campaign to increase awareness of breast cancer and drive mammogram screenings, organizations should identify where priority service lines and their patient community’s health risks and capacity intersect, and develop an engagement strategy accordingly. For some health systems, that might mean heart health is a top priority because of their strong cardiology service line and a high-risk patient community.


Identify patient next best actions


The majority of people know that preventive care, like mammograms and colonoscopies, is good for the management of their health. But knowledge is very different from action. As humans, we are very good at finding reasons not to take healthcare-related actions: we’re too busy, we don’t want to, we assume the risk pertains to other people, we don’t know where to go. The list goes on. We have shown, however, that a strategy that leverages an organization’s data effectively can change our human tendency towards inaction (or avoidance), as it removes some of the burden from patients.

Like Amazon’s “Buy Now” button, healthcare organizations need to make the process of taking action as frictionless as possible. When communicating to patients, like any consumer, it’s important that the call to action is hyper-relevant and timely, which should tie to the aforementioned ultimate strategy.

For example, we worked with an East Coast-based health system to design and execute a breast cancer campaign that targeted patients at high risk for the disease. We began with a propensity model to identify which patients within the community were at high risk of developing breast cancer based on well-established risk factors and previous health records.

The approach was to educate those patients about the risk of breast cancer, the importance of early and consistent screening, and opportunities to protect themselves through lifestyle and nutrition choices. As part of those communications, the health system would suggest the next best actions a patient could take; for example, a call to schedule a mammogram screening appointment or a check-up with their doctor. On the system side, they had mapped out which possible actions they wanted patients to take, all intended to drive improved health outcomes, to get them in for care and keep them engaged on their care journey.


When we look back at health system data from the past year, we see a dramatic increase in proactive patient engagement. For example, when a health system sent a text message containing general information related to COVID-19, we saw a 50-70% increase in open rates. Email open rates hovered between 40-50% (the industry average is around 20%).

What this means: there’s a large appetite amongst healthcare consumers for valuable healthcare information; they want to hear from their providers. The way to deliver that value, especially as it relates to increasing access and improving revenue from preventive care, is through effective data-driven patient engagement strategies. Only when the healthcare system can demonstrate it understands its patients’ health priorities, concerns and preferences, can we drive improved outcomes.


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