Medicare is clearly driving value-based payments and MSSP programs in a direction such that providers will have to take on risk. With that in mind, there are core capabilities providers will need to be successful and analytics is one of them.
Just how to effectively harness data and analytics, especially where population health is concerned, is a central topic that Tim Putnam, Chief Executive Officer of Margaret Mary Health and Anna Loengard, Chief Medical Officer of Caravan Health, will explore at their upcoming HIMSS19 session "Data analytics as a Population health Compass."
Putnam said that from his perspective as early adopters of population health in the transition from volume to value, they have seen a lot of benefit from it. However, though CMS is pushing toward risk from a reimbursement standpoint, the real-life for a lot of community hospitals in taking that on is not more than just a potential monetary penalty. By extension it's actually a threat to their very existence.
Learn on-demand, earn credit, find products and solutions. Get Started >>
"We are putting our lives on the line and our communities on the line by doing this," he said.
As an early adopter, they had to have small practices and hospitals work together and form networks. Small to begin with but when you look at the data and how many lives it takes to become one of these orgs that has definable outcomes, we need to become much larger organizations.
Loengard pointed to a couple things that might make the adoption of population health less risky and ultimately, more beneficial. First, she said optimize the revenue that can be generated in population health initiatives.
A second area where gains can be made and strategies born is in claims data. When people get clams data, it's often the first time in most cases that they have ever had "visualization" into where their patients are getting all of their care and, according to Loengard's experience, it is always eye-opening. You learn something about utilization patterns i.e. like seeing most of their patients are not getting joint replacement surgery with your system is therefore losing out on revenue to some competing hospitals. You might take that data, explore why patients aren't using your facilities for such procedures and make the needed changes to boost patient and procedure volume.
"Utilization and post acute, end-of-life that we see pretty consistently that people learn from and are then able to take action around where are the greatest opportunities to improve care in ways that are beneficial to the community and to the hospital," she said.
Loengard and Putnam will offer more insights at HIMSS19 in a session titled "Data Analytics As a Population Health Compass." It's scheduled for Thursday, February 14, from 1:00-2:00 p.m. in room 207C.
Focus on The Business of Healthcare
In December, we take a deep dive into what top business decision makers need to know about digital transformation.