Healthcare is bankrupting the nation, and instinctively health system leaders know that they will never make more money than they are making in this industry today. That said, leaders have to take a very non-traditional approach to margin growth shifting away from throughput and towards outcomes and patient loyalty. Value-based care (VBC) is central to that strategy.
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Value-based care isn’t easy. It requires a pretty significant technology and infrastructure investment to be successful. For organizations who have made that commitment, there are still two challenges we see population health shops facing in their value-based care efforts.
1. Patient Leakage: Simply put, to receive financial benefit, the job of a healthcare organization is to keep patients healthy and to reduce the cost of care. However, organizations lose their ability to influence those costs if the patients they are responsible for under VBC go outside of their networks for treatment. An organization might have the best in-house care in the world but that doesn’t matter when a patient walks out the door to a competitor.
Healthcare organizations losing patients must then ask “why are our patients going out of network?” The answer may be that there wasn’t a seamless, connected experience that made patients want to stay. Instead, they turn to referrals from family or friends when an organization would prefer them look for guidance inside their own network.
2. Patient Compliance: A healthcare organization may have solved the leakage problem, and may offer excellent care that makes patients want to return again and again, but when patients leave the doors of the health system or practice and don’t follow their provider’s instructions, they may end up back in the office or emergency department a week later.
Addressing the problems
So how do you fix these issues? The answer is scalable connectivity. The connected model must allow organizations to engage and educate patients, but also to provide the care team with visibility and monitoring of patients in different care settings — including home — so that they can coordinate across the care continuum. Patients shouldn’t wonder what’s happening with their care and care teams shouldn’t wonder what is happening with their patients.
Patient compliance with care instructions may feel like it is out of the control of a value-based care organization, but the care team that has visibility into a patient and has the connectivity to intervene if something is wrong is also the care team that can educate throughout a patient’s care journey, ensuring they’re staying on track.
Healthcare organizations seeking to retain patients and encourage compliance must offer great service, remote patient monitoring, education and engagement for patients and family members, as well as coordination across all the different segments of their patient experience. These distinguishing features will drive better outcomes and patient loyalty.
Turning to digital
When considering how to increase connectivity to succeed in value-based care, digital engagement solutions have presented a very attractive solution. Let’s consider each of these challenges again, and the role digital engagement may play.
As we revisit leakage, it is important to note that the root of the leakage issue is low patient loyalty. Patients will choose a provider that is known for quality and efficiency. They want to get better and they want visibility into the steps providers are taking to get them there.
Improving outcomes for patients has always been the primary goal, but value-based care has created a renewed incentive for low readmissions and complications. When patients leave the four walls of the care setting, physicians lose visibility into risk factors that may develop. Digital engagement tools can provide the remote monitoring information a provider would need to identify real-time risk and intervene before costs and complications escalate.
In addition to better outcomes, patients are also looking for a more efficient and transparent experience. Today, people digest information digitally. Whether by app, in a browser or in another way delivered to their smartphones, consumers from all walks of life want to be addressed via technology. In fact, an NTT Data study found that 50% of patients would leave their provider for a better digital customer experience, which clearly demonstrates digital engagement as a driver of loyalty.
Unfortunately, a loyal patient doesn’t always equal a compliant patient. When we reconsider the compliance issue, there is a gap in accountability. In an ideal world, we would have the resources to hold every patient accountable. Unfortunately though, that isn’t the case today.
Imagine trying to call every one of your patients, every day, to check on their status, escalate red flags and assuage their fears that they’re being overlooked and disconnected from their provider. The sheer manpower required would be extremely large, and you still wouldn’t have enough hours in the day to devote to personalized care for each. Alternatively, you could scale the same activities with a digital solution like GetWell Loop, engaging all patient populations before and after admission through automated daily check-ins.
Providers and healthcare organizations need to be upfront about the reality on the ground and work to correct it. Nowadays, when patients leave a hospital or a doctor’s office, they often get a packet of information stapled together, which likely ends up under the passenger seat of their car.
This may be a slight exaggeration, but there’s a hard truth buried in the hyperbole: there needs to be a way for providers to connect with patients after they are out of their sight, to ensure they’re following through with instructions.
For those trying to get ahead in this market, digital engagement is an investment worth making. It tackles leakage and compliance in one fell swoop. Sure, all of this could be done without a digital solution if there were enough people on staff and a large enough budget, but the plain truth is that most healthcare organizations don’t have those things.
So how can you implement a digital strategy?
The low-hanging, cost-cutting fruit has been picked. Organizations are now focused on competing via differentiation. GetWellNetwork’s clients come to us to do just that. Turning to a comprehensive digital suite of tools like GetWell Anywhere helps health systems that are participating in value-based care achieve their patient loyalty and quality goals.
By providing amazing service that starts in the home, goes to the clinic, follows patients to an inpatient setting and is with them after discharge and beyond, GetWell Anywhere offers the seamless five-star service organizations need to survive.
It’s time to challenge where things have been and acknowledge the evolution in consumer expectations. Providing a digital experience is the only way to shift the old model and address the new economics of today’s healthcare market.