What is the Importance of Unified Data in Healthcare?

It is no secret that healthcare can be complicated and oftentimes overwhelming, and when it comes to healthcare data it is no exception. This leads healthcare leaders to ask the question how can a healthcare organization improve their information flow to ultimately improve patient outcomes? According to Healthcare IT Today, “A future of lower cost and higher quality healthcare – rapidly growing adoption of health information technology is a key lever in achieving that future. Achieving this goal; however, requires strategies and technologies for overcoming the problem of disparate”. In this article we will explore what unified data means within the healthcare industry and the challenges and benefits that your healthcare organization may be impacted by embracing unified data. 

What is Unified Data?

A unified data model brings together your healthcare organizations data from different sources into one centralized database, making it easier to analyze data. This concept is slowly being embraced by healthcare organizations, as the importance of data and value-based care increases. Unified data isn’t a trend that isn’t going anywhere anytime soon though. With that being said, with any change in the healthcare industry comes challenges and ultimately benefits as well.  

Challenges You May Face

Industry leaders are reluctant to embrace unified data because of the challenges that an organization may face. Some of these challenges include: 

  1. Different data formats from different systems 
  2. Changing industry standards
  3. Finding the right time and resources to have unified data

Although embracing Unified Data may cause you to face these challenges, keep in mind the benefits far outweigh the challenges for both your healthcare organization and patients.

Benefits of Unified Data 

The reality is data is the future of healthcare. Unified data allows you to make not only smarter decisions but decisions based upon data provided to you through your unified data approach. Other benefits include:

  1. Helps drive value in healthcare 
  2. Identifies opportunity to reduces Cost 
  3. Unlocks the value of complex healthcare data sets 
  4. Provides you a full picture of a patient health care and cost 

Many organizations are aware of these benefits but don’t know where to start and truly leverage their own data. 

Prepare for the future

Simply put, you can make Smarter, Data-Driven Decisions with Unified Data. Unified data allows you to position your organization for success by leveraging your organization’s data from as many resources as possible. Primavera partners with healthcare organizations and their leads to do exactly that.

We have the power to integrate and process both your front-end EHR/EMR data and back-end Payers data as well. What does this mean? Our Analytics platform is able to provide a clear picture in real-time of your patient population risk, financial status, clinical gaps and patient gaps. This level of data integrity and unified data allows you to have a more proactive approach with your data and not to wait for outcomes to improve.  HealthCare’s embrace of data and value-based care is not going away, and Primavera is on a mission to work with you no matter where you are at in this journey. 

Reach out to our team to learn how we can help retrieve and analyze your healthcare organizations data! 

(888)-667-2219

info@primavera.care

Request Demo Form

Rolian RuizWhat is the Importance of Unified Data in Healthcare?
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How to Successfully Maximize Healthcare Reimbursement and Improve Revenue Cycle

Revenue Cycle Management (RCM) is a top priority for all healthcare organizations. Balancing collection on difficult claims, keeping cash flowing for your organization, all while staying focused on delivering quality patient care can be difficult. Therefore, it’s important for every healthcare organization to have a process and billing team in place to continuously maximize reimbursement and improve revenue cycle management. Implementing and successfully running your RCM can be a challenging and involved process, so let’s take a look at what important factors contribute to maximizing your RCM. 

Financial Data Review 

Processes should be in place to review all facility data and verify patient information to ensure you are getting the most money for the services provided to their community. This ensures that all claims have been processed correctly and mediate for claims that process out of order from previous billings. 

Streamline Reimbursement

Delay or denial of claims can adversely affect the revenue cycle of a healthcare organization. You should have a billing process in place that ensures your claims will pass through the fiscal intermediary correctly the first time, ensuring you accurate and faster payments. It is essential to follow up on claims that may be sitting in an unpaid status to process them through the system faster. While streamlining reimbursement may be a timely process for a billing team, it is just as important to have a billing process that implements: 

  1. Providing reliable and accurate information
  2. Having knowledge of and meeting billing requirements for each individual payor
  3. Submitting claims within the prescribed time frame allowed
  4. Having a expert and experiences team at hand to reduce admin burden

Confidentiality

RCM and medical billing includes protected health information, so understanding the importance of keeping records confidential is critical to your RCM. On top of that, a healthcare organizations process for collecting information from facilities and for submitting claims should be done with regard to following HIPAA standards, ensuring PHI and records stay confidential. 

Strong Billing and RCM Team 

At the core of maximizing your RCM is having an experienced and expert billing team manage your RCM. Your billing team should have a proactive strategy utilizing a combination of monitoring and prioritizing workload including stringent monitoring of timely filing and timely billing timelines. Just as important is keeping your billing team updated and trained on rcm rules is essential to financial success. 

Experience the Primavera Difference

Implement and successfully run your RCM to maximize reimbursement with Primavera Billing and RCM Services. The Primavera Approach leverages technology and deep experience in billing and coding to help your operation reach peak performance with your practice’s RCM. Providing revenue optimization and improved medical economics by reviewing all financial data, streamlining reimbursement, providing confidentiality and providing a strong billing team.  

Discover how Primavera’s leading billing and RCM services can transform your RCM. When you choose Primavera Health Billing and Revenue Cycle Management Services, you choose a team that holds extensive experience in medical billing and revenue cycle management services as well as:  

  • Extensive EMR and billing systems experience
  • Consultants are certified with multiple platforms
  • Deep experience with all Medicare, Medicaid, and commercial payers nationally
  • A technology approach, to simply data and an organization’s process to improve patient outcomes and overall practice performance 
  • A team that works alongside you to develop rules and assist with implementing new and improved RCM processes

Reach out to us today to learn how we support you to continually improve your RCM across your organization. Fill out the form below to schedule your Free Consultation with our team! 

(888) 667-2219

info@primavera.care

Rolian RuizHow to Successfully Maximize Healthcare Reimbursement and Improve Revenue Cycle
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Primavera NLS

Next level Security

At Primavera, we take security a step further to deter and prevent any cyber intrusion and protect data. We implement strict internal procedures for access control on client and patient data. The procedures we have in place are Primavera’s NLS, or Next Level Security. Our NLS ensures your data is encrypted, private and protected against cyber-attacks and data breaches that impact the healthcare sector. 

Primavera NLS is a combination of Security & Compliance, Established Standards & Protocols and Secure Tools & Systems. Below list the ways we continuously strive for Next Level Security for our clients, patients and their data.

Security & Compliance 

  • HIPAA Process
  • Audit and Log Activity
  • IP Masquerading Implementation
  • Vulnerability Scans
  • Automatic Device Log Off
  • Penetration Testing
  • Two Factor Authentication
  • Secure Socket Authentication
  • Encrypted Patient Data 
  • Force Strong Passwords

Established Standards & Protocols

  • Disaster Recovery Plan
  • Firewall and Router Configuration Review
  • Establishment of Permissions
  • Compliance Program Activities
  • Security Awareness Program Training
  • System Patching and Secure Development Practices

Secure Tools & Systems 

  • SFTP (Secure Data Transfer)
  • Anti-Virus Protection
  • GCP Cloud base
  • Cloudflare
  • Web Application Firewall
  • CircleCi – CICD
  • Atlassian Suite
  • Segregated Data Storage
  • Data Access Logs 
  • Strict Authorization Protocols 

Our client’s data protection is one of the primary goals at Primavera, we always ensure your data and security is top priority.

To learn more contact our team at (888) 667-2210 or info@primavera.care.

Rolian RuizPrimavera NLS
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Bridging the Gap with HEDIS® Measures

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a tool used by U.S. health plans to measure performance of care and service. Simply put, HEDIS® involves a review of health care services to ensure care is meeting quality standards. Both payers and providers are looking to provide better quality, greater value, and improved patient satisfaction. Therefore, it’s important for every health plan to evaluate quality and performance regularly to ensure the plan’s continued success. 

The Impacts of HEDIS® Measures 

HEDIS® measures span all types of clinical care and strive to ensure that providers are following evidence-based guidelines. Impacts of HEDIS® measures are felt far and wide and cover everything from the appropriate use of anxiety medications to ensuring patients receive the preventive screenings and immunizations they need. 

These measures were introduced by the National Committee for Quality Assurance (NCQA) and scores are used by the Centers for Medicare & Medicaid Services (CMS) to monitor performance for managed care organizations (MCOs). Performance on these measures impacts Medicare’s star ratings and NCQA health plan ratings. Improving HEDIS® scores is a priority for health plans as they analyze great amounts of data to identify opportunities for ongoing improvement.

While HEDIS® is an effective tool for measuring quality, tracking performance against these measures can be challenging for payers. The retrieval of data can be a complicated process when working with providers to collect data from electronic medical records (EMR) and paper charts. Other challenges include getting providers to respond and release records upon request which may come in the form of fax, mail, EMR or secure FTP sites.  

Provide Better Data, Better Measures and Better Care with Primavera 

Fortunately, Primavera’s Health’s new initiative of bridging the gap with the HEDIS® measures will provide better data, better measures and better care. We believe health organizations should be able to analyze HEDIS performance levels and trends to determine where to focus efforts and overcome HEDIS challenges. 

Here are a few ways Primavera’s technology can help healthcare organizations address HEDIS® headaches and improve scores. We design Comprehensive strategies to identify and close gaps in care for you to obtain the best quality scores — and get your members the care they need.

  1. HEDIS® Analytics & Reporting: Tracking, monitoring and improving scores at the patient, provider, location, insurance pcp and payor level – Allowing your team to measure direct impact
  2. HEDIS® & STAR Analytics: Develop and customize your healthcare organizations HEDIS measures to fit organization needs and expectations
  3. Identify Care Gaps: Data-driven insights to identify patient care gaps that directly impact HEDIS® measures

Primavera customizes value-based care solutions based on your needs, to drive better clinical and financial outcomes. Providing revenue optimization and improved medical economics. Our experience and expertise in value-based care strategy and implementation allows you to focus on ensuring patients get the right care – with quality health outcomes.

Discover how Primavera’s leading HEDIS® measures tracking system can transform your data into actionable insights, allowing you to monitor, improve and automate HEDIS® scores in our Data Analytics platform year-round.

Reach out to us today to learn how we support you to continually improve HEDIS® outcomes across your organization.

(888) 667-2219

info@primavera.care

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Rolian RuizBridging the Gap with HEDIS® Measures
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Key Considerations in Healthcare Strategy when Transitioning to Value-Based Care 

Key Considerations in Healthcare Strategy when Transitioning to Value-Based Care 

Value-based care (VBC) is a holistic care approach and payment model, versus the fee-for-service model that largely still dominates the industry. VBC models have greatly increased in use and implementation and continue to become more widely used but it’s not an easy change for all healthcare organizations to make. Which leads to the question – 

What are the best strategies when transitioning to VBC? This blog will guide organizations towards strategies to consider when adapting VBC to ensure a successful transition.

Rethink Delivery of Care 

Transitioning to value-based care requires that healthcare system participants rethink how to deliver and compensate for healthcare. Delivery of care impacts patients and all healthcare providers involved in a patient’s circle of care. In current fee-for-service  models, healthcare is delivered and paid for by an individual patient’s visit or follow-up procedure. 

In VBC all of the services and visits necessary to treat the patient’s symptoms are bundled – and this extends across specialties to include all doctors, specialists, and nurses, as well as preventive and supportive therapies such as; doulas, counselors, and nutritionists. Delivery of care significantly shifts away from quantity to quality with VBC, with care centered around patient outcomes. Shifting to delivering quality care goes hand in hand with a holistic care approach. 

Defining “Holistic” Care

There are 2 facets to holistic care with a VBC model. One is the actual care continuum itself as we mentioned, where all services are combined. The other is the financial extension of that approach with a bundling method that combines costs for these services based on treatment outcome. In VBC models the incentive is on successful treatment and continued preventive care rather than step by step actions administered throughout the diagnosis.

Educate Healthcare Providers and Teams

Paving the path to success within an organization begins with education initiatives to accelerate the transition to VBC. The adjustment from fee-to-service to VBC can be a tedious adjustment for providers that have been practicing with the focus of quantity versus quality for years. Ensure that the entire healthcare organization is equipped to participate by educating them about the core tenets of value-based care, no matter how big or small of a role they will play.

Measuring Care Impact 

A new strategy that is needed in VBC models is to implement tools like real-time risk assessment and continuous patient evaluation through software and applications and platforms for two main reasons.

  1. Hospitals and care facilities must be able to evaluate with up-to-date information from all involved care providers and practitioners within a patient’s treatment in order to coordinate care and create accurate and effective compensation practices. Patient data must be able to be updated and communicated within standard compliances, and communication channels must be maintained between both practitioners and patients. 
  2. Providers must be thoughtful and clear. This requires a rethinking of how healthcare is delivered by providers but also all specialists the patient is going to see. It also requires that the communication between any provider and the patient is as seamless and accessible as possible. This means having a centralized method or platform that encompasses outreach, communication, provider connections, transportation logistics, and transactions across the full continuum of care.

There is no shortage of valuable data available to healthcare organizations and they must commit to quality improvements through reliable data. 

Why make the change

VBC causes healthcare leaders to rethink the processes and elements that have the greatest impact on a patient’s outcome. It also provides a clear format as to what is or is not a covered benefit for the patient. This approach leads to lower costs overall for facilities and providers through a few key shifts:

Risk analysis and shared responsibility

All providers and practitioners/departments work together to reduce collective spending. Risk is assessed and prioritization makes it easier to provide pertinent care.

Shared Savings

Financial load is shared among practitioners/providers so that saved funds in one department can be redirected to another to keep the collective on budget.

Bundling Cost

Bundling allows patients to have input on their care and opt out of services they don’t need. Patients don’t overpay, and providers can accrue savings from unused services.

Understanding the shared health needs of patients will make it easier to see how a VBC model can help you save on cost through bundling and shared savings across departments. With this information you can design your own unique solution to improving the quality of care for your patients. The analytics and data collected from Primavera’s Data Analytic platform to facilitate VBC success will make tracking health outcomes and patient data easy so you can justify and analyze cost and outcomes.

VBC creates great experiences and outcomes for patients, and generates higher bottom lines for providers. Though it is increasing in popularity, VBC is not dominating the entire market – but due to its flexibility and adaptive/integrative nature it is ideal for mitigating gaps in care that can be created by pay-per-service models. 

Patient-first care does not have to negatively impact revenue generation. At Primavera, we help you create the best strategies to implement VBC solutions into your practice. The goal is to close gaps in patient care and improve outcomes without incurring additional costs – and in fact, reducing them.

Through revenue optimization (driving down costs by improving efficiencies in coding and determining cost drivers), and identifying growth trends, we are able to help identify your specific benefits from switching to VBC. 

Reach out to us today to continue the conversation on how to position your healthcare organization to benefit from value-based care. 

Rolian RuizKey Considerations in Healthcare Strategy when Transitioning to Value-Based Care 
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Increasing Profits Through Value-Based Care

Hospitals and health systems are looking to optimize their revenue by turning to value-based care from volume-based care. Widely used models where the number of patients determines the financial success of the practice is now being offset with the option to profit off preventive care and increase the quality of care.

So how does this work? And what are the benefits to patients, and to the healthcare facility and its different departments?

Incentive & Bonus Payments

VBC programs award practitioners based on the quality of care they are providing through bonuses and incentive programs. As an example, with the center for Medicaid and Medicare services, there are 5 key VBC rewards programs:

  • End-Stage Renal Disease Quality Incentive Program (ESRD QIP)
  • Hospital Value-Based Purchasing (VBP) Program
  • Hospital Readmission Reduction Program (HRRP)
  • Value Modifier (VM) Program (also called the Physician Value-Based Modifier or PVBM)
  • Hospital Acquired Conditions (HAC) Reduction Program

Incentive programs like these are meant to motivate care optimization and help the healthcare industry as a whole move away from fee-for-service models and into bundled care solutions that are compensated by overall patient health.

The drive for this performance-based shift has been evolving since the passing of the 2010 Affordable Care Act (ACA). In 2018, this alternative payment model (APM) comprised roughly 36% of total U.S. healthcare payments up from 25% in 2015.

To work, bonuses and incentives can’t stay stagnant and they have to grow proportionate to APM revenues, and live in a 10-20% range of projected cash compensations.

Stabilized Cash Flows

Perhaps the most attractive benefit of VBC is that there are more predictable cash flows in times of service fluctuation (e.g., the coronavirus pandemic). Financial losses were top of mind during the height of the pandemic as hospitalizations increased exponentially, affecting providers in unexpected ways, and testing their ability to adapt. Those practices able to embrace digital telehealth solutions were able to stay more nimble without compromising their data collection and intake processes, further – those with VBC models were able to continue to receive regular payments vs fee-for-services models which saw a staunch decline. 

“Hospitals and health systems that have mostly recovered from the initial hit of the pandemic had invested before the crisis in areas such as hospital-at-home services and digital capabilities that allowed rapid expansion into virtual care and remote patient management.” 

Additionally, certain healthcare practices may actual thrive under a virtual care model:

Some specialties, such as mental health, may find stronger footing via virtual visits. Healthcare provider executives surveyed by HRI most frequently cited mental health and psychiatry (58%), family medicine (56%), obstetrics and gynecology (46%) and pediatrics (44%) as the specialties in which their organizations will offer virtual visits in 2021.

Payers may wrestle with how to reimburse and, in some cases, provide virtual care. Pharmaceutical and life sciences companies may have to determine where they can and should plug in, literally. Providers may continue to improve the patient experience and be careful not to create new disparities in the health system through lack of technology access.

With 95% of large US employers covering telehealth, up from 56% in 2016, business leaders will have a say in how virtual care is used and how it should be woven into the healthcare system.

The revenue (and analytics) of VBC models stabilizes revenue and spending by improving patient outcomes and creating more consistent care continuums – identifying gaps in care, and bundling treatment modalities for preventive care options.

Healthy patient populations create revenue as new reimbursement policies put forth by payers and government agencies promote preventive solutions.

Go Beyond Hospital Walls

A big proponent of the success of VBC is that it is adaptable and, because it is focused on treatment success over fee-for-service, this model is able to be more flexible in incorporating external therapies within approved networks. 

With greater accessibility comes the need for greater amounts of data to manage it and along with the implementation of VBC comes the need for real-time applications and management platforms to capture and analyze patient data; for reporting but also to mitigate risk. 

When it comes to utilizing these applications; for patients it needs to be incredibly easy to use – accessible with the tap of a screen, and for providers it needs to be able to track multiple practitioners, patient records, manage transportation, and facilitate transactions, all with regulation levels of security and compliance.

At Primavera, we focus on real time results and make it easy to access the complete member record, case management, scheduling, transportation, healthcare analytic care data and financial analytic data for your patients and practice. This integrated support is what gives VBC models the organization and adaptive structure they need to support a variety of patients – even under unexpected circumstances – without compromising profitability.

Curious how this solution could work for you? Reach out to us today to get started. 

Rolian RuizIncreasing Profits Through Value-Based Care
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Time Sensitive Opportunity: Federal funds made available to help FQHCs modernize technology tools to better leverage patient-level data

HRSA just recently announced it is making $90 million available to federally qualified health centers to assist them as they transition to new reporting requirements that have been redesigned to collect more and better data on social determinants of health. The modernization effort aims  to increase the granularity of the data being collected by leveraging advances in health information technology and aligning with other interoperability standards and reporting requirements in other federally funded health care programs.

Why shift to patient-level data?

HRSA believes this will help to better evaluate the Health Center Program, provide targeted training and technical assistance, and advance quality improvement research. Such research may lead to improvements inequitable access to high-quality, cost-effective care, including addressing the ongoing impacts of COVID-19 and supporting responses to future public health emergencies

For health centers, standardization of patient-level health data will enable the identification of populations most at risk for health disparities and will provide data to inform potential clinical interventions.

What can the funds be used to do?

Funding will support improvements in infrastructure, such as health information technology, and enhanced data collection and reporting through FHIR (Fast Healthcare Interoperability Resources).  The funds will support patient-level reporting and enable them to better identify, measure, and investigate disparities in health care use and health outcomes by race, ethnicity, age, and other important demographic factors, and to more precisely target their resources accordingly. Furthermore, the ability to collect, house, and report standardized patient-level health data will support health centers’ participation in critical population health surveillance activities during public health emergencies. Big takeaway here… this will help position the organization to be eligible for future funding opportunities.

Some award specifics:

This is a time-sensitive opportunity. Applications are due May 23, 2022 by 5pm ET. HRSA anticipates that awards will be made on or around August 1, 2022.

Approximately $88.4 million in supplemental funding is available in FY 2022 to support additional allowable ARP activities, including UDS+ activities, through the end of your ARP period of performance (March 31, 2023 for HRSA-funded health centers and June 30, 2023 for look-alikes).

HRSA anticipates awarding approximately $60,000 per awardee through one-time supplemental funding. Depending on the number of approvable applications, HRSA may adjust award amounts consistent with funds available for this supplemental funding opportunity at the time award decisions are made.

HRSA expects to release funding on or around August 1, 2022, for use throughout the remainder of your American Rescue Plan Act (H8F or L2C) award’s period of performance (until March 31, 2023 for HRSA-funded health centers and June 30, 2023 for look-alikes),

Partner with Primavera Health 

Primavera Health provides a customizable ecosystem of tools that allow providers to capture the required data by a FQHC when you need it most. We were founded and built with a brain for business and a heart for patients providing a data analytics solution that is centered around real-world applications in the healthcare sector. Primavera’s Core Values are Actionable Intelligence, Ease-of-use and Performance that not only meet but exceed your reporting requirements.

Providing technology that was designed by a team of healthcare professionals and industry experts to serve healthcare professionals through a complex IT architecture and relationship database systems – we are here to help your FQHC succeed. Having in-depth experience building out government funding reporting systems for our clients, we are positioned to partner with FQHCs to succeed. For example, we recently completed reporting interface that tracks key patients services being provided through the Volunteer Health Services Program in Florida.

To learn how Primavera can directly support you to meeting HRSA application deadline while improve required reporting across your organization, Reach out to us today or sign up to schedule a demo with Primavera in the below form!

 

Request Demo Form

Rolian RuizTime Sensitive Opportunity: Federal funds made available to help FQHCs modernize technology tools to better leverage patient-level data
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Primavera Webinar: Excelling in the Business of Value-Based Care

Primavera Presents: Excelling in the Business of Value-Based Care

  • Are you looking to learn more about how to adopt and embrace Value-Based Care?
  • Is your organization lacking a Value-Based Care strategy and implementation?
  • Are you hoping to improve patient care while reducing costs but don’t know where to start.

If you answered “Yes” to any of those questions, this webinar is for you.

Watch the webinar below to learn great insights and solutions on how you can not only engage in Value-Based care but benefit with the help of our expert advisors:

  • Value-Based Care fundamentals – what it might mean to different people at a practice
  • Important key drivers necessary in VBC that help align, patients, payers and providers in a value-based structure
  • Risk payer settings and how to best position your practice in an advanced payment model
  • How important technology and administrative infrastructure is in setting your practice up for success
  • I think VBC is right for me – What steps can/should I take?

Rolian RuizPrimavera Webinar: Excelling in the Business of Value-Based Care
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3 Benefits of Primavera’s Value-Based Care Advisory Services

Value-based care (VBC) is an alternative to the historical fee-for-service (FFS) model of healthcare reimbursement. It means transforming the payment model such that the healthcare provider – the physician, for example – is paid not necessarily by volume and the types of procedures, but is compensated for the quality of care – a more coordinated and appropriate approach. 

VBC  affords many opportunities for improving the quality and continuity of care for healthcare organizations and their patients. Transitioning to it can be a challenging and involved process, so let’s look at why this model is worth your consideration.

Reduce out-of-pocket spending with higher quality deliverables

Out-of-pocket payments (OOP) are highly influential financial elements across the health sector – particularly in lower-economic populations where financially vulnerable patients are significantly affected by OOP costs.

Decreasing OOP costs seems like a no-brainer for improving patient retention and increasing access to care – so the issue boils down to does reducing OOP compromise care quality? The short answer is it doesn’t have to. 

VBC models promote higher-quality care deliverables for reduced OOP models by increasing patient monitoring (through easy access to resources, education, and communication), increasing simplicity for revenue optimization and collection, and resource management through risk assessment and data analytics.

Improve coordination between physician behavior and incentives

From changes in clinical and organizational workflows to the underlying data infrastructure of practices, it can be challenging to coordinate an effective relationship between physician behavior and offered incentives. In the VBC model this relationship can reflect greatly in both preventive and post care follow ups. 

“VBC helps to promote care delivery transformation” by facilitating a redesign in approach for primary care efforts – a lot of which is supported by newer technologies, apps, and cloud-based solutions. 

Physician payment incentives for value remain small relative to total compensation, with continued emphasis on productivity. Challenges cited include the lack of a single enterprise wide electronic health records platform for information exchange, limited ability to influence specialists who were not exclusive to the organization, lack of payer cost and utilization data to manage costs.”

The success of incentive programs depends more and more on the communication success between patient data and the ease of that data’s implementation across the organization. Features like real-time risk assessment, one-touch communication, and transaction capabilities make continuous care models not only sustainable, but achievable.

Drive customer retention

Health is a well-intentioned business, and the number one way to boost business is to create more affordable, higher-value products. In this desire, patients are no different than any other consumer – they want the best care value for their money and in return you will drive retention and an expanding client base.

While retention is largely cost-based, in VBC models it depends on all factors, let’s break down the implementation.

Getting Started

A Primavera advisor can help you transition to value-based care and improve the quality, value and care for your patients.

Step one is to evaluate the best ways for your practice to engage in VBC contracting and care initiatives. This leads us first to revenue optimization.

  1. Revenue Optimization

We mentioned offering higher quality products for a better value. This begins with lowering medical costs by first improving your infrastructure efficiencies and determining cost drivers such as MRA and MLR. 

  1. Improving Results

Next we want to improve healthcare results by closing gaps in care tracking and collecting data more efficiently to help identify outliers, diagnose trends, and mitigate risk while simultaneously improving patient outcomes through more efficient communication and care plan execution. 

  1. Membership

Finally, we want to use data analytics to identify positive growth trends within your patient-base to help expand on successful programs, and improve the patient panel experience and care delivery systems; consultation, transportation, payor services, vendor relationships, etc.

VBC all ties back to retention as it is a client-first solution – but one which doesn’t exclude the needs and values of the organization. Is it a newer and less widespread model than traditional care systems? Yes. But that makes sense since it has evolved with brighter technologies that can make it not only an appealing, but an extremely practical solution.

Solution Enablement

Our software solutions enable you to improve the quality of care and enhance the patient experience while helping you take control of your financial future through VBC models and overall streamlining of your organization.

Transitioning to value-based care is challenging; requiring resources, time, a priority shift, and evaluation but with a Primavera advisor – it’s easier together. Let us map out the plan and tools you will need to be successful. 

Primavera customizes value-based care solutions based on your needs, to drive better clinical and financial outcomes. Providing revenue optimization and improved medical economics. Our experience and expertise in value-based care strategy and implementation allows you to focus on ensuring patients get the right care – with quality health outcomes.

Reach out to us today to learn how we directly support you to continually improve outcomes across your organization by encouraging collaborative models like value-based care.

Rolian Ruiz3 Benefits of Primavera’s Value-Based Care Advisory Services
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Virtual Care: More Than Just Telehealth

Telehealth solutions are software solutions. They help manage patient’s, data, and allow for scheduling, delegation, and administration. In many minds, this is where the definition of telehealth stops; but this service is more than a tool – it is a platform for communication and for engaging with your patients on a human level.

The goal is to extend care beyond the physical limits of a brick and mortar facility, adding virtual care – without compromising care quality.

Barriers to Care

Healthcare has had to adapt over the last few years – and it will need to continue to evolve now that new technologies are being integrated. Healthcare providers have had to be creative and rethink how they can provide the best care given realistic hurdles. In the spirit of growth, there are two main barriers to care we want to bring up:

Cost of Care

Quality care costs money – both for practitioners and for patients. From operational costs to testing; staffing, and maintenance, the hidden and everyday costs of healthcare facilities can be mitigated by virtual solutions. Telehealth is instrumental in reducing those costs for both providers and care recipients.

Industry analysis of telehealth solutions by Cigna, shows that telehealth not only reduces in-person healthcare visit costs by “$93 for non-urgent needs, but a specialist visit via telehealth was $120 less than an in-person visit, and a virtual urgent care appointment was $141 less than going to an urgent care clinic.”

Additionally, telehealth solutions “omit the need for unnecessary (mandatory) lab testing “which led to an average savings of $118 per episode of care.”

Access to Care

Access to care rolls right into our point regarding cost, since financial flexibility for patients is definitely an incarnation of accessibility – but so are transportation, education, and healthcare provider options. Telehealth by its nature is connective – and is constantly growing in it’s inclusivity and offerings for healthcare plans.

Internally, telehealth platforms make it easy to schedule transportation, host virtual calls and appointments, schedule follow-ups, and provide self-care and educational materials, etc. Solutions like Primavera begin addressing accessibility with the technology itself:

  • No App is required to be downloaded by patients – this is particularly great for geriatric populations, or those with other mobility or cognitive pathologies. Care can be reached with the single touch of a button.
  • Virtual visits are supported with high resolution video, easy to access invites, and tools available in multiple languages.

For providers, accessibility of technology is also mission-critical:

  • Enjoy built-in schedulers
  • Intuitive dashboards supported by up-to-date analytics
  • Seamless integration into your software suite
  • And support of multiple participants

Consider This

Managing your patients by population or diagnosis helps to manage remote health offerings, therapies, and protocols. Organization with the help of telehealth helps to bring these strategies to your patients in the form of easier access.

If your patients have better accessibility they will provide you with greater amounts of data which will help build your analytics and power real-time risk assessment features based on patient information.

Security is Accessibility

The more popular telehealth solutions (and remote tools in general no matter your sector) become, the more prevalent security will be. If you platform is not secure it is not safely accessible to you or your patients so look for a platform that supports:

  • Remote monitoring options for all integrated devices
  • Audit logs
  • SSL encryption
  • Is HIPAA compliant

Assessing Risk

Once you’ve bolstered your security, you can safely go about assessing, managing, and actioning risk to improve your care continuum and streamline the resources for your practitioners.

We mentioned real-time risk assessment earlier, let’s dive a bit deeper.

Real-time data allows you to get a view of the top utilizers of your platform, determine which are at high risk, and track progress in comparison to established industry benchmarks. With Primavera, real-time data is auto populated to support risk stratification, and to help detect outliers (not just highest utilizers).

You also can also track by pharmacy usage and other metrics to determine high risk cases in an non-static environment, meaning that the data is always updating and adjusting your view accordingly.

Building Engagement

Prioritizing patient outcomes through your software with tools like risk management and coordinating care via scheduling and connectivity are just a few of the ways that telehealth helps elevate the care cycle without increasing the cost.

Building engagements through software is something that is becoming an integrated aspect of our daily lives already, from our social meetups to our day-to-day work environments. Extending that ease of access to our healthcare is a critical part of a quality telehealth solution.

Yes, telehealth is important in our current times with notable health obstacles and the need for remote access – but this cannot be the only purpose your solution serves. We are all humans after all, and healthcare is easier together.

Want to learn more about what telemedicine can do for you? Schedule your demo with us today.

Rolian RuizVirtual Care: More Than Just Telehealth
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