Today's healthcare landscape is rapidly shifting away from fee-for-service delivery and financial models and wading deeper toward value-based care. The new models, including bundled payments, accountable care organizations (ACOs), and government programs or mandates that promote value-based purchasing, are all different approaches designed to improve continuity and coordination of care while reducing healthcare costs overall. Providers adapting to these new models will find themselves working together in ways they haven't before. The most successful among them will champion their efforts on what connects them – care transitions.
Care Transitions: The Bridge to Success in Emerging Models of Care
Value-based models focus on the care a patient receives across the care continuum and reward quality and efficiency. Care transitions impact the quality of the entire episode of care for that patient. Unfortunately, care transitions often:
- Lack standardized processes and workflows
- Rely on manual, fax and telephone-based processes
- Are complicated and impact high-risk, high-cost patients the most
Much of the variation can be attributed to the manual tasks and processes in care transition workflows not supported by technology. This can lead to miscommunication, delays and confusion, which can lead to poor patient outcomes and increased costs.
Care transitions tend to “parallel transitions in health status,” so the sicker a patient is the more he or she will utilize the healthcare system and the more transitions he or she will encounter. As U.S. healthcare spending continues to rise, initiatives that reduce costs while improving care for high-risk, high-cost patients will have the greatest impact. One way to do both is to improve care transitions across the community.
There are four steps organizations can take to make their care transitions a positive and effective contributor to today's high-quality, low cost initiatives and meaningful use requirements.
- Build a high-quality post-acute network adherent to emerging regulations (CJR, BPCI, CoPs, etc.) As hospitals partner with more post-acute providers, the financial and regulatory needs of each post-acute provider type – and how they may differ from that of other types in the network – must be considered. It is important to build relationships with these providers while simultaneously identifying those that will enhance the quality of the network.
- Standardize and streamline workflows across the network Care transition workflows must be designed to provide each level of care with the consistent, high-quality information they need to make better decisions faster. To do that, you need technology. Standardized care transition workflows should apply to every accountable provider in the network.
- Proactively measure outcomes and efficiency, both in and between settings It is no longer enough to measure quality and efficiency just at the hospital. Care that a patient receives at each setting has downstream effects on providers later in the episode. Measuring care episodes across the network can help pinpoint bottlenecks and quality issues by showing where patients are spending the most time and by evaluating the care they are receiving at each setting.
- Employ secure technology that supports care transitions Establishing post-acute networks, care transition workflows and appropriate measures of quality and efficiency are all vital steps toward improving care transitions, but none will scale without technology. Technology, specifically interoperable technology, is fundamental in supporting connected networks. It reduces process variation, enhances security, tracks and measures data, and provides vendor-agnostic value offerings.
In an evolving healthcare environment that values – and pays for – coordination and continuity of care, few processes are more important to a network of providers than the ones that connect them. Provider organizations that adapt and thrive in the coming years will be those that recognize the importance of care transitions, establish strong transition of care workflows and invest in the technology to make them work.
Curaspan's best-in-breed platform automates transitions of care workflows to create efficiencies, reduce process variation and optimize collaboration during the patient-transition process. With a secure platform for coordination between providers and the analytics necessary to optimize performance, Curaspan's solutions are the foundation for initiatives like ACOs, HIEs, value-based purchasing and other evolving models of care and reimbursement. For more information, please visit Curaspan.com.