The healthcare landscape is rapidly changing. Provider needs, payment models and care delivery are becoming increasingly complex, while patients, payers and employers are demanding more value from the services they’re paying for. Moreover, reimbursement penalties implemented by the Centers for Medicare & Medicaid Services (CMS) are forcing healthcare organizations to rethink how they can effectively control the cost and quality of care they provide.
As a result, payers and providers are now turning more of their attention to managing patients through the entire care journey. But they struggle due to disintegrated technology, inefficient processes and lack of real-time data and communication needed to improve care decisions.
By 2018, CMS will require 50 percent of payments to be value-based, meaning providers are compensated for healthy outcomes rather than each service provided. According to Xerox research, many payers and providers are concerned about how they are going to contain costs and measure outcomes. They will require additional support in the areas of analytics, technology and people-based services.
Xerox Health Outcome Solutions combines the analytics, clinical, technology and administrative services needed to improve both financial and clinical outcomes as healthcare organizations make the transition to value-based care. We address payer and provider concerns by analyzing value-based contracts that underperform and identify populations that will have the highest impact on results.
Fierce Healthcare named Xerox a population health management/patient engagement solutions winner in its Fierce Healthcare’s Fierce Innovation Awards 2016.
For example, if patients with chronic conditions are unnecessarily using the emergency room, we would roll out a suite of services to achieve better outcomes and reduce the cost of care from sub-optimized chronic care therapies. In this instance, these services might include omni-channel communication services to engage patients and a 24/7 nurse line that allows them to seek advice when needed. This can help determine, for example, when a symptom or flare-up can be managed at home or with a visit to a primary care physician rather than a trip to the emergency room. Care coordinators may also ensure patients are scheduling regular appointments and filling and taking medications as prescribed to stay healthy.
Value-based care can be both risky and costly for healthcare organizations. However, our platform provides tools, expertise and support that can help organizations deliver against their value-based care contracts.
About the AuthorMore Content by Erin Isselmann