Community Hospitals Should Use Engagement Tools to Keep Patients in Network, Lower Costs

Some patients prefer community hospitals to larger health systems when it comes to seeking medical care, because a local organization can offer a personal touch that is hard to come by in large systems.

For some, large systems seem impersonal and hard to navigate. The community hospital, on the other hand, can be a place that seems comfortable and familiar, where you’re on a first-name basis with your physician and your care team.

If healthcare is to function properly, patients should have the choice between large health systems and community hospitals. Both offer distinct benefits to patients. But healthcare is not working as it should.

Community hospitals are under tremendous financial strain and finding it difficult to keep their doors open. The good news is there are steps community hospitals can take to maintain their independence and deliver higher quality, more affordable care. 

The pressures of forming ACOs 

Increasingly, community hospitals have been joining Accountable Care Organizations (ACOs), which is a way of pooling resources to deliver high-quality care to Medicare beneficiaries and commercial payors.

When community hospitals join ACOs, they face even more pressure to keep patients within their network and not lose them to the competition. They are also under the gun to deliver the highest quality care as cost-effectively as they can.

The key to keeping patients in-network and achieving good health outcomes at a lower cost is engaging with the patient.

But the transition to the ACO model requires investment in new care management capabilities to help reach patients at home to ensure that they are on track and getting the care they need. The logical path is for ACOs to hire nurses and care management specialists to engage with patients and keep them healthy. This is an expensive way to scale.

How to engage 

There are plenty of reasons why healthcare providers want to engage with their patients once they have been discharged.

Patient engagement — in whatever form it takes — has been shown to boost patient loyalty, improve patient experience, increase the number of patient referrals, improve quality, and drive down costs.

Providers are not so much struggling with the ‘why’ of patient engagement, but the ‘how.’

A community hospital or other providers can always add more care managers or call center workers to the roster, and these new staffers can keep in close contact with patients once they’ve been discharged. This might help the hospital reap many of the benefits of patient engagement, but at what cost?

Already strained, healthcare providers are not looking to dig deeper into the budget to hire more staff.

The answer is to automate patient engagement, so providers can keep in close contact with patients at scale without hiring an army of employees.

Fortunately, the technology to accomplish this exists today. 

How to not lose the patient 

When a patient wants a medical check-up, he or she will call their physician’s office to make an appointment. But when a person is out of the house and experiences pain or other sudden, alarming symptoms they check in at the nearest hospital.

A person who desperately needs care is not likely to think about in-network providers versus out-of-network providers, but will simply call an ambulance.

Unfortunately, other stakeholders in healthcare do have to think about such things. A patient going out-of-network looks like a patient that has been lost, and there is a price to pay nowadays for losing patients to other providers.

This is the situation that the community hospital needs to avoid, especially if it is part of an ACO.

Patient engagement means learning what is really going on with the patient. It means that if there are warning signs of a health complication, the care team will be able to spot it. It means getting the right information to the right patient at the right time, so that he or she can avoid triggers that can bring on complications. It means helping them get access to the best healthcare resources at the right time.

No one will ever be able to prevent accidents or truly unforeseeable health complications. But with patient engagement, community hospitals and other organizations can make major gains when it comes to keeping patients from going to other providers.

Better care, lower cost

Engaging with patients daily yields many benefits, including making patients happier and improving outcomes. It also directly affects the bottom line, by offering a way to deliver a higher quality of care at a lower price.

Patients who engage with providers daily are less likely to experience health complications and hospital readmissions. They are more likely to be discharged to home, where they are safely and carefully monitored by their providers.

Healthcare providers also find that patient engagement solutions enable front-line staff to handle many inquiries from patients that might otherwise be directed to physicians, which means physicians can spend more time administering care.

And patient happiness — which may not sound impactful to fiscal problems — can also benefit the budget. Happy patients write positive online reviews, which increases referrals, bringing new patients in the door. Happy patients also refer friends and family to their provider.

It just takes the right tools

Community hospitals are a choice that should always be on the table. There’s no reason why they shouldn’t be.

Daily patient engagement means getting out in front of the types of health complications that can send patients running to another provider. It’s a powerful tool for keeping them within the network.

It’s also the key to delivering higher quality care, because patient engagement means establishing genuine connections. Patient engagement gives providers insight into how their community of patients is doing right now — data that is not available in an electronic health record (EHR).

Patient engagement means keeping patients out of the hospital as much as possible, keeping complications from spiraling and making sure they have the information they need to properly manage their own health when they’re outside the care setting.

These outcomes ease the financial burden.

We are fortunate today to be able to scale the impact of care teams with automation. It’s the way to reach every patient every day. That’s not just something community hospitals should be doing, it’s something every provider should be doing.