May 16, 2024
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Historically, fee-for-service payment models in healthcare have rewarded quantity over quality of medical services. In recent years, however, there has been a shift to value-based care, such as bundled payment models that incentivize providers to achieve better health outcomes at lower costs. Through bundled payment models, health care providers are reimbursed for treating a patient’s medical condition across the entirety of their episode of care.
A lower quality of care leads to poor compliance, increased post-procedural complications, hospital length of stay (LOS), and readmissions. According to a report published in 2020, 97% of physicians relied on fee-for-service and/or salary while 36% obtained compensation from value-based payments. Under the value-based care model, physicians will only receive full reimbursement for effective care as their salaries are directly related to care quality.
The adoption of technology is playing a major role in the success of the shift towards value-based care, as digital care journey platforms have been proven to increase the quality of patient care in line with recent demands; patients are requesting more convenient care, while also experiencing increased patient engagement from their healthcare providers. These tools provide healthcare providers with heightened visibility into the patient journey via remote patient monitoring. Healthcare organizations that offer higher quality services at a lower cost, an enhanced patient experience and increased convenience are poised to succeed in the shift towards value-based care.
“With the ongoing shift that we've been seeing to value-based care, we're finding that it's simply not enough to just attract and book patients for health care services. Today, health systems are also looking to engage and monitor patients outside the four walls of the institution to guide patients as they go through a surgery, cancer journey, and maternity care journey, all of this to ensure that patients have not only a really great consumer experience but also the best possible health outcome.” - Dr. Joshua Liu, Co-founder/CEO of SeamlessMD
Leveraging Digital Patient Engagement for Improved Clinical Outcomes
With the shift towards value-based care, U.S. hospitals have responded by more actively participating in value-based programs such as the Hospital Readmissions Reduction Program and Bundled Payments for Care Improvement in order to improve the quality care delivery and clinical outcomes while reducing the total cost of care. Technology like digital patient engagement applications help forward-thinking healthcare institutions succeed under value-based care models, specifically as it relates to the reduction of high-cost services such as ED visits, LOS, and readmissions. Hospitals can limit these factors by embracing digital care journeys to more effectively monitor patients in and out of the hospital, as well as using the technology to analyze patient data to determine what incidences often lead to higher rates of ED visits, LOS and readmissions.
Furthermore, digital care journey platforms help improve patient quality of care by providing them with the tools to effectively self-manage from home. That is, patients have access to an evidence-based education library that helps with pre-procedural preparation and post-procedural recovery. They can also use the platform to help stay on track with their care plan with just-in-time reminders, track recovery symptoms (e.g. pain levels, surgical incision photos, etc.) and receive automated guidance on how to manage issues patients would otherwise frequently call about. Addressing these issues through virtual means ultimately reduces patient visits and therefore, healthcare costs. Patients that are actively engaged on digital care journey platforms feel less anxious and more connected to their care team throughout their care journey - leading to better outcomes.
For example University Hospitals (UH) implemented a digital care journey platform with the goals of creating a more standardized care experience for patients and achieved the following outcomes:
Gregory D. Rushing, MD in the Division of Cardiac Surgery at UH shared:
“Phone call volumes can overwhelm staff and negatively impact operational efficiencies; by providing patients with the tools to effectively self-manage from home, patients are less likely to require multiple follow-up phone calls. The implementation of SeamlessMD has led to a reduction in phone calls, contributing to improved staff satisfaction and clinical operations.”
Technology Facilitates Improved Data Collection
Digital care journeys allow for more effective collection of patient-reported outcomes (PROs) from patients that can be leveraged to improve both the quality and cost of patient care. These digital platforms automate PRO data collection, such as pain scores, opioid use, and validated surveys (example PROMIS) across the episode of care. The processing of this data by these digital tools as well as dashboards create a connected care setting that can help providers detect abnormal events and allow for the patient’s care team to act in real-time to customize care and intervene if necessary to prevent potential health complications.
Collecting and analyzing PRO data is becoming a top priority for healthcare reimbursement as part of value-based care models. For example, in the United States CMS requires hospitals to collect PROMs data from a minimum percentage of hip and knee replacement patients as part of their mandatory bundled payments.
“Digital patient engagement has been an integral part of our digital transformation for total joint replacement patients – helping us improve the patient experience through interactive patient education, remote patient monitoring and automated PRO data collection. The technology enables outstanding patient care by collecting valuable patient-reported outcomes data for continuous quality improvement.” Dr. Friedrich Boettner, Orthopedic Surgeon, Hospital for Special Surgery
PRO collection also helps health systems to more closely evaluate and improve provider performance, clinical outcomes, and the patient experience. As this data gets processed, it can help set performance standards and benchmarks which would subsequently inform funding systems. Digital platforms help to standardize the delivery of PROs and provide higher quality data interpretation.
It is clear that Integrating a digital patient engagement platform into a value-based care model can help improve health outcomes, the patient experience, and total cost of care.
Interested in learning more about how value-based care has led to an increase in the adoption of digital care journeys?
Listen to Dr. Joshua Liu discuss how technology helps providers, payers, and patients succeed with value-based care on this podcast episode focused on “Digital Patient Engagement For Value-based Care.”
During the discussion, he reveals how technology can collect the patient voice at scale, automate personalized care, and flag potential issues to shift care from being reactive to proactive.
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Historically, fee-for-service payment models in healthcare have rewarded quantity over quality of medical services. In recent years, however, there has been a shift to value-based care, such as bundled payment models that incentivize providers to achieve better health outcomes at lower costs. Through bundled payment models, health care providers are reimbursed for treating a patient’s medical condition across the entirety of their episode of care.
A lower quality of care leads to poor compliance, increased post-procedural complications, hospital length of stay (LOS), and readmissions. According to a report published in 2020, 97% of physicians relied on fee-for-service and/or salary while 36% obtained compensation from value-based payments. Under the value-based care model, physicians will only receive full reimbursement for effective care as their salaries are directly related to care quality.
The adoption of technology is playing a major role in the success of the shift towards value-based care, as digital care journey platforms have been proven to increase the quality of patient care in line with recent demands; patients are requesting more convenient care, while also experiencing increased patient engagement from their healthcare providers. These tools provide healthcare providers with heightened visibility into the patient journey via remote patient monitoring. Healthcare organizations that offer higher quality services at a lower cost, an enhanced patient experience and increased convenience are poised to succeed in the shift towards value-based care.
“With the ongoing shift that we've been seeing to value-based care, we're finding that it's simply not enough to just attract and book patients for health care services. Today, health systems are also looking to engage and monitor patients outside the four walls of the institution to guide patients as they go through a surgery, cancer journey, and maternity care journey, all of this to ensure that patients have not only a really great consumer experience but also the best possible health outcome.” - Dr. Joshua Liu, Co-founder/CEO of SeamlessMD
Leveraging Digital Patient Engagement for Improved Clinical Outcomes
With the shift towards value-based care, U.S. hospitals have responded by more actively participating in value-based programs such as the Hospital Readmissions Reduction Program and Bundled Payments for Care Improvement in order to improve the quality care delivery and clinical outcomes while reducing the total cost of care. Technology like digital patient engagement applications help forward-thinking healthcare institutions succeed under value-based care models, specifically as it relates to the reduction of high-cost services such as ED visits, LOS, and readmissions. Hospitals can limit these factors by embracing digital care journeys to more effectively monitor patients in and out of the hospital, as well as using the technology to analyze patient data to determine what incidences often lead to higher rates of ED visits, LOS and readmissions.
Furthermore, digital care journey platforms help improve patient quality of care by providing them with the tools to effectively self-manage from home. That is, patients have access to an evidence-based education library that helps with pre-procedural preparation and post-procedural recovery. They can also use the platform to help stay on track with their care plan with just-in-time reminders, track recovery symptoms (e.g. pain levels, surgical incision photos, etc.) and receive automated guidance on how to manage issues patients would otherwise frequently call about. Addressing these issues through virtual means ultimately reduces patient visits and therefore, healthcare costs. Patients that are actively engaged on digital care journey platforms feel less anxious and more connected to their care team throughout their care journey - leading to better outcomes.
For example University Hospitals (UH) implemented a digital care journey platform with the goals of creating a more standardized care experience for patients and achieved the following outcomes:
Gregory D. Rushing, MD in the Division of Cardiac Surgery at UH shared:
“Phone call volumes can overwhelm staff and negatively impact operational efficiencies; by providing patients with the tools to effectively self-manage from home, patients are less likely to require multiple follow-up phone calls. The implementation of SeamlessMD has led to a reduction in phone calls, contributing to improved staff satisfaction and clinical operations.”
Technology Facilitates Improved Data Collection
Digital care journeys allow for more effective collection of patient-reported outcomes (PROs) from patients that can be leveraged to improve both the quality and cost of patient care. These digital platforms automate PRO data collection, such as pain scores, opioid use, and validated surveys (example PROMIS) across the episode of care. The processing of this data by these digital tools as well as dashboards create a connected care setting that can help providers detect abnormal events and allow for the patient’s care team to act in real-time to customize care and intervene if necessary to prevent potential health complications.
Collecting and analyzing PRO data is becoming a top priority for healthcare reimbursement as part of value-based care models. For example, in the United States CMS requires hospitals to collect PROMs data from a minimum percentage of hip and knee replacement patients as part of their mandatory bundled payments.
“Digital patient engagement has been an integral part of our digital transformation for total joint replacement patients – helping us improve the patient experience through interactive patient education, remote patient monitoring and automated PRO data collection. The technology enables outstanding patient care by collecting valuable patient-reported outcomes data for continuous quality improvement.” Dr. Friedrich Boettner, Orthopedic Surgeon, Hospital for Special Surgery
PRO collection also helps health systems to more closely evaluate and improve provider performance, clinical outcomes, and the patient experience. As this data gets processed, it can help set performance standards and benchmarks which would subsequently inform funding systems. Digital platforms help to standardize the delivery of PROs and provide higher quality data interpretation.
It is clear that Integrating a digital patient engagement platform into a value-based care model can help improve health outcomes, the patient experience, and total cost of care.
Interested in learning more about how value-based care has led to an increase in the adoption of digital care journeys?
Listen to Dr. Joshua Liu discuss how technology helps providers, payers, and patients succeed with value-based care on this podcast episode focused on “Digital Patient Engagement For Value-based Care.”
During the discussion, he reveals how technology can collect the patient voice at scale, automate personalized care, and flag potential issues to shift care from being reactive to proactive.
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