Value-based care success requires patient adherence and the right technology

Mark Heinemeyer
Mark Heinemeyer

Across healthcare, organizations are faced with the challenge of adapting long-standing workflows and care routines in order to succeed under new value-based care models. Post-acute care organizations are not exempt from this challenge and must develop new practices to ensure costs are well managed and care delivers quality patient outcomes.

Consider the Bundled Payment for Care Improvement initiative, for example, which sets a single spending target for all applicable health services provided during a clinical episode of care over a specified period of time. Thus a 90-day episode of care for total joint replacement might include the hospital stay, physician services, outpatient care, a skilled nursing facility, home health, and readmission. All the participating providers are incentivized to help patients recover quickly and avoid being readmitted to the hospital, where care costs are highest. For post-acute providers, who also rely heavily on referrals from other providers, care coordination and quality patient outcomes are essential for the long term success of their business.

Patient adherence in healthcare: essential for successful outcomes

Patient adherence to care plans are particularly important under a bundle payment program. Consider a patient who is discharged to his home after 45 days of treatment at a SNF. Even though the patient is no longer under the direct care of the SNF, the facility still has a vested financial interest in the patient adhering to his prescribed care plan as it reduces the risk of complications that could lead to readmission.

In order to maximize their compensation, SNFs are motivated to coordinate with patient caregivers, home health agencies, and pharmacists to ensure patients remained in engaged in their own care.

In fact, across the healthcare spectrum, patient adherence is critical for successful outcomes. Whether in the individual's home, within the four walls of a hospital, at a managed care facility or at the local pharmacy, patient adherence to prescribed care plans is essential for achieving quality outcomes. Despite its tremendous potential to deliver value, patient adherence often remains an elusive goal.

However, healthcare reformers remain convinced – and rightly so – that consumer engagement is one of the most critical factors for the long-term viability of value-based care models. Fortunately, the healthcare sector is beginning to embrace new technologies that leverage machine-learning, predictive analytics, and behavior assessment to drive patient adherence and sustain consumer engagement.

The right technology is crucial

The use of technologies such as predictive analytics and machine-learning have already been proven to impact the quality of care for the post-acute care segment. For example, a 2015 study published in the Journal of the American Medical Informatics Association found that the incorporation of EHR data into predictive analytics algorithms increases the accuracy of identifying patient at high risk of harmful falls by more than 10%.

In home-centered care, the use of remote care solutions that integrate machine-learning and predictive analytics with remote patient management technologies are also helping improve chronic disease management, in-home and remote care delivery, staffing predictions, and population health risk assessment. Remote monitoring tools can automate routine tasks, such as capturing vital signs.

The addition of analytics provides valuable insights into the health of an individual based on collected data and contextual information. Over time, as additional data is captured and available for analysis, these insights become more precise. In the world of value-based medicine, this type of data is critical for predicting the likelihood of adverse events so that caregivers have adequate time to enact proactive measures that enhance outcomes.

Digital health tools and apps can also be incorporated to assess the unique personalities of each individual to accurately identify potentially non-adherent patients. The incorporation of behavioral-based tools can automatically flag individuals that are high risk for non-compliance and allow caregivers to tailor their communications, treatments and medication plans. By leveraging technology that recognizes the uniqueness of each patient, care and engagement can be customized to optimize patient adherence and health outcomes.

Seek proven technologies

CMS is to be lauded for innovative programs such as the Bundled Care Improvement program, which promotes efforts to improve patient care and reign in healthcare costs. These programs are also making organizations more aware of the need for updated technology solutions to enhance their ability to meet value-based care objectives; at the same time, providers are realizing that not all technology suites are created equal.   

Case in point: despite the proliferation of wearable health devices and remote monitoring systems in recent years, the preventative impact related to adverse events and readmissions among individuals with chronic disease across the sum total of this technology has clearly been underwhelming, and often-times confusing. Consumers, payers and providers realize they must choose their technology wisely to ensure the delivery of care that is both beneficial and cost-effective.

Across the post-acute care segment in general, financial and clinical success requires technology solutions that are proven to monitor and encourage patient engagement and adherence. Ideally solutions should promote the prescriptive utilization of collected data and the empowered personalized engagement of participants, as well as leverage remote monitoring, machine-learning and predictive analytics.

New care models demand better care coordination, and post-acute care providers that have proven their ability to efficiently deliver optimal health outcomes will be an invaluable asset to their partner organizations.

Mark Heinemeyer serves as Chief Collaboration Officer for Wanda Inc. He recently held senior executive positions with NantHealth and Global Care Quest. 


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