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The Health Plans’ Role in Meeting MACRA Requirements – MACRA Monday

Posted on July 17, 2017 I Written By

The following is a guest blog post by Karen Way, Health Plan Analytics and Consulting Practice Lead at NTT DATA Services. This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

When the Medicare Access and CHIP Reauthorization Act (MACRA) became an official federal ruling for the healthcare industry in 2015, the act replaced the previous Medicare reimbursement schedule with a new pay-for-performance program focused on quality, value and accountability. In short, the legislation rewards healthcare providers for quality of care, not quantity.

While many discuss the impact on providers, what is the health plans’ role in aiding health systems and physicians to meet MACRA requirements?

MACRA provides multiple opportunities for health plans to increase and improve collaboration with provider networks. Recommendations on how health plans can accomplish this include sharing information and services, creating new partnerships and bringing about financial awareness as the legislation continues to take effect.

Sharing Data

One of the requirements under MACRA is for providers to enhance clinical measures and data analytics to strengthen members’ experiences. Health plans can assist by recognizing where providers lack expertise in data-related facts to offer input and support where it’s most beneficial.

For example, a provider may not have as much knowledge on advanced data science, but health plans can share their predictive models and tools to strengthen analytics. Sharing advanced technical infrastructure to facilitate data exchange will enable providers to access a more complete picture of members’ profiles. In return, the picture will provide a higher quality service to individual members, as well as opportunities for health plans to continue offering tailored consulting and data support.

At its best, sharing data to improve clinical measures is a win-win scenario. The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service. Just as HEDIS calls for measurement, MACRA also encourages health plans to aid providers with reporting standards. Under these rules, health plans are required to record a wealth of information on members, and when shared with providers, the tide lifts all boats.

Partnering to Manage Risk

Some of the changes under MACRA are reminders for providers to be highly aware of risk management. Providers will seek strong partners with the necessary skills, experience and knowledge to ensure they do not take on risk greater than they can support. To assist, health plans should enter into risk-sharing relationships, such as value-based contracts, with high-performing providers.

Health plans should actively strive to be strong partners by enabling robust data analytics that support quantitative action plans in the areas of quality and clinical care gaps, medical cost and trend analysis, population health, as well as member-risk management. As health plans partner with providers, they should also stay flexible on potential changes to provider payments as the pay-for-performance model(s) mature over time.

Financial Awareness

Health plans also need to be aware of the financial considerations that result from increased value-based contracting for small and large providers.

Under MACRA, smaller providers and individual physicians are more likely to be exposed to potential increase in costs, which may result in additional provider considerations. As Medicare payments shrink, these providers will look to shift costs to other payers, making contract negotiations more difficult and potentially increasing unit costs for some services. Large physician groups, or those located in markets with progressive healthcare systems, will look to negotiate even higher reimbursement rates due to the potential for increased competition.

Health plans should also be aware of potential impacts beyond Medicare fee-for-service (FFS), which is the initial focus of the MACRA legislation. Pay-for-performance is likely to extend beyond Medicare FFS into other health plan lines of business, such as Medicaid or commercial plans. For example, under MACRA, Centers for Medicare and Medicaid Services stated it would consider permitting Medicaid Medical Homes to count as an alternative payment model if participating practices would risk at least four percent of their revenue in 2019 and five percent in 2020.

Why This Matters

Overall, MACRA creates a tall order as it aims to increase pay-for-performance and decrease care based on quantity. This notion is an altruistic adjustment for the health system and each party has a specific role to play to achieve the dream. But the backbone of this goal is collaboration between health plans and providers. Collaboration will result in shared clinical measures, awareness and management of risk, lower healthcare costs and, most importantly, improved patient outcomes.

EMR Impact on Patient Care Differs, But Doctors Never Win

Posted on July 14, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Nearly all physicians agree that using EMRs isn’t great for their relationship with patients. But, hospital-based and office-based physicians seem to have different reactions to the problem. (Neither group is happy with their lot, but I’m sure you already guessed that much.)

The study, by researchers at Brown University and Healthcentric Advisors, is based on the open-ended answers provided by 744 doctors to a survey question: “How does using an EHR affect her interaction with patients?” (The question was posed by the Rhode Island Department of Health in 2014.)

In analyzing the responses, researchers found that office-based physicians and hospital-based physicians had different concerns about patients care and EMR use.

Office-based physicians, who typically bring their computer into the exam room, worry that staring at a computer screen will undermine the quality of their visit with the patient. “[It’s] like having someone at the dinner table texting rather than paying attention,” one doctor wrote.

Hospital-based physicians, for their part, usually do their record-keeping on EMRs based outside the exam room.  They said that record-keeping took up too much time, leaving little for direct contact with patients. Said one physician: “I now spend much less time [with] patients because I know I have hours of data entry to complete.”

To maintain their standards of patient care, physicians are doing the data entry at home rather than at work, sometimes many hours at a time. Others are taking CME classes which promise to help them integrate EMR use with patient consults in the least disruptive manner. But nobody had found any good solutions to the patient care conundrum.

Of course, we knew most of this already. This study just offers some added color to a picture we’ve already seen. Both patients and physicians are suffering under current models of EMR use, and there’s little relief on the horizon.

Yes, a few physicians said that EMRs hadn’t impacted their time with patients. This might’ve been encouraging, but this group included one physician who treated newborns and another using a scribe to handle data entry during consults.

And there were a few respondents that cited positive aspects of EMR use in patient care. For example, one hospital-based doctor noted that EMRs offered him an easy way to look at a comprehensive patient history. Some office-based physicians noted that web-based patient portals were improving their patient interactions.

But the striking thing here is that few if any physicians suggested that EMRs offered any ongoing clinical benefits. As researchers have discovered many times over, most doctors saw their EMR use as a work requirement rather than a clinical exercise. This only underscores that as they presently work, EMRs benefit administrators, not care providers.

I wish I was so smart that I’d come up with some sort of solution to this problem. I haven’t. But it doesn’t hurt to harp on the existence of the problem. We should remind ourselves over and over again that it’s time to roll out EMRs that support clinicians.

Did Meaningful Use Really Turn EMRs Into A Commodity?

Posted on July 12, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Not long ago, I had a nice email exchange with a sales manager with one of the top ambulatory EMR vendors.  He had written to comment on “The EMR Vendor’s Dilemma,” a piece I wrote about the difficult choices such vendors face in staying just slightly ahead of the market.

In our correspondence, he argued that Meaningful Use (MU) had led customers to see EMRs as commodities. I think he meant that MU sucked the innovation out of EMR development.

After reflecting on his comments, I realized that I didn’t quite agree that EMRs had become a commodity item. Though the MU program obviously relied on the use of commoditized, certified EMR technology, I’d argue that the industry has simply grown around that obstacle.

If anything, I’d argue that MU has actually sparked greater innovation in EMR development. Follow me for a minute here.

Consider the early stages of the EMR market. At the outset, say, in the 50s, there were a few innovators who figured out that medical processes could be automated, and built out versions of their ideas. However, there was essentially no market for such systems, so those who developed them had no incentive to keep reinventing them.

Over time, a few select healthcare providers developed platforms which had the general outline EMRs would later have, and vendors like Epic began selling packaged EMR systems. These emerging systems began to leverage powerful databases and connect with increasingly powerful front-end systems available to clinicians. The design for overall EMR architecture was still up for grabs, but some consensus was building on what its core was.

Eventually, the feds decided that it was time for mass EMR adoption, the Meaningful Use program came along. MU certification set some baselines standards for EMR vendors, leaving little practical debate as to what an EMR’s working parts were. Sure, at least at first, these requirements bled a lot of experimentation out of the market, and certainly discouraged wide-ranging innovation to a degree. But it also set the stage for an explosion of ideas.

Because the truth is, having a dull, standardized baseline that defines a product can be liberating. Having a basic outline to work with frees up energy and resources for use in innovating at the edges. Who wants to keep figuring out what the product is? There’s far more upside in, say, creating modules that help providers tackle their unique problems.

In other words, while commoditization solves one (less interesting) set of problems, it also lets vendors focus on the high-level solutions that arguably have the most potential to help providers.

That’s certainly been the case when an industry agrees on a technology specification set such as, say, the 802.11 and 802.11x standards for wireless LANs. I doubt Wi-Fi tech would be ubiquitous today if the IEEE hadn’t codified these standards. Yes, working from technical specs is different than building complex systems to meet multi-layered requirements, but I’d argue that the principle still stands.

All told, I think the feds did EMR vendors a favor when they created Meaningful Use EMR certification standards. I doubt the vendors could have found common ground any other way.

A Few Thoughts on #HIT100

Posted on July 11, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As many of you know, I’ve been working hard lately to keep the #HIT100 alive since I think the sharing of gratitude that happens with #HIT100 nominations is a phenomenal thing. For the most part, the good of the #HIT100 has outweighed the bad. As someone recently tweeted (sorry I couldn’t find the specific tweet), the kindness and appreciation that you see in the #HIT100 Twitter stream stands in stark contrast to much of what is happening in the world and on social media. That’s a beautiful thing and so I want as many people to pariticipate in sharing the great things happening in healthcare IT social media as possible. With that in mind, check out the details of the #HIT100 and participate.

While I think the #HIT100 provides so many good things, it’s sad that some in the #HIT100 community have had some bad experiences. Unfortunately, social media is a community and you can’t control it. However, what you can do is support those who get hurt, work to encourage the good side so that it far outweighs the bad, and encourage those that act inappropriately to change. I think Dr. Brian Stork’s tweet was an apt response to some of the negative experiences:

One reason I think a lot of people take the #HIT100 too seriously is that rank has value even if it’s only perceived value. However, given the crowdsourced process of the #HIT100, your rank on the list shouldn’t matter much. Here’s what I wrote back in 2014 about it:

The list as a whole is quite interesting and a great way to discover new and interesting people in healthcare IT. However, specific rank on the list is meaningless to me since it can easily be gamed. For example, if you nominate a lot of other people, then you’re very likely to get reciprocal nominations and be at the top of the list. Not to mention, with just my own Health IT related Twitter accounts I could get someone to the top 50 if I’d wanted. Although, I didn’t.

Given this, I recently tweeted the following:

I was serious about rank not mattering. I can’t choose what the rest of the community chooses to do, but my plan is to publish the top 100 accounts based on #HIT100 nominations but to publish them in a random order that hopefully will randomly resort every time you refresh the screen. Plus, I’ll be working to publish other lists like I’ve done in past years including Twitter accounts with only one #HIT100 nomination. All of this points to the idea that the list is great for social discovery. Not to mention all the gratitude and support that happens with each nomination.

I hate to see anyone on the #HIT100 getting hurt by the process. However, I hope the good that comes from it will far outweigh the bad. The best way I know how to make sure that’s the case is for all of us to share goodness with others during the #HIT100 nominations. What I find amazing about the process is the more good you share, the more goodness you’ll receive in return. Plus, that happens regardless of some easily gamed rank. Let’s all spread more good in the health IT social community and the world.

The Top Three Hidden Impacts of MIPS – MACRA Monday

Posted on July 10, 2017 I Written By

The following is a guest blog post by Tom S. Lee, PhD, CEO & Founder, SA Ignite. This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

While most providers know the Merit-based Incentive Payment System (MIPS) will have escalating financial impacts, there are additional strategic and operational concerns that go along with managing MIPS participation. The MIPS score will impact areas beyond just clinicians’ Medicare reimbursement, including public reputation, clinician recruiting and compensation, and reporting for participants in alternative payment models (APMs).

  1. Public Reputation

Clinicians participating in MIPS and most Medicare accountable care organizations (ACOs) will have a MIPS score that determines their Medicare Part B reimbursement. The same score can impact public reputation because CMS will publish the scores on the Physician Compare website and make the data freely available to the public. Companies like Google, Healthgrades, Consumer Reports, Yelp, and others can use that data to incorporate the MIPS score into its clinician ratings and review systems. If an organization chooses to do just the minimum in 2017 to avoid the penalty, it means its clinicians could have a public performance score as low as 3 out of 100, while competitors who fully perform and report could have much higher publicly reported scores.

MIPS scores become a permanent part of each clinician’s resume because CMS binds the annual score to the clinician’s unique national provider identifier (NPI). So even if a clinician switches organizations, the historical score, along with the reimbursement or penalty, will follow the clinician, with the new organization absorbing the financial impact earned by the clinician up to two years prior at a different organization.

Estimates indicate that the revenue impact of consumers swayed by MIPS scores can be significantly larger than just the direct reimbursement impacts of MIPS. According to this article, a 1-star increase on Yelp leads to 5 to 9 percent increase in a business’ revenue. Using CMS’ data on Medicare Part B payments by specialty, this could mean an increase ranging from $4,468 to $8,042 per year per clinician for an internal medicine doctor and up to $10,705 to $19,269 per year per clinician for a cardiologist.

And, it may be much harder to convince a consumer who did not select a clinician based on an unfavorable MIPS score to re-evaluate that clinician in the future, even if the clinician’s score ultimately increases.

  1. Clinician Recruiting and Compensation

Understanding a clinician’s historical MIPS scores will be important to an organization properly evaluating and contracting with that clinician. When recruiting new clinicians or acquiring practices, healthcare organizations are mindful that they can inherit poor scores from other organizations’ program decisions. Conversely, clinicians will increasingly seek to join organizations with a good track record enabling its clinicians to achieve high MIPS scores, which positively impacts the resumes of all those clinicians.

In addition, organizations are seeking to align clinician compensation with MIPS financial and reputational impacts so look for an increasing number of compensation plan designs to directly incorporate MIPS scores and category scores as key performance indicators.

  1. Reporting Obligations of APM Participants

Although a healthcare organization may make a strategic decision to join an Alternative Payment Model (APM), such as a Medicare Shared Savings Program Accountable Care Organization (ACO), clinicians who are part of that organization are not necessarily exempt from MIPS. For example, if a clinician joins the organization after the final August 31st CMS determination of APM participation, then those clinicians will still need to fully report for MIPS or face a penalty. This is true for late-joining clinicians in both MIPS APMs as well as Advanced APMs, which typically qualify for a MIPS exemption.

Regardless of when clinicians join a Medicare Shared Savings Program (MSSP) Track 1 ACO, the ACO must manage MIPS eligibility, performance, and reporting for all clinicians, in addition to its ACO program obligations. This stems from the fact that MSSP Track 1 ACOs are not Advanced APMs.

How to Engage Clinicians Regarding MIPS

Beyond educating clinicians and leadership about the hidden impacts of MIPS, much of the important work to be successful under MIPS involves engaging clinicians in taking ownership of their responsibilities under the program. Some best practices:

  1. Recognize the importance of patient and clinician satisfaction
    • Reinvigorate support from leadership on the importance of both pillars
  2. Collaborate with clinicians
    • Let their voices be heard regarding both the explicit and hidden impacts of MIPS
  3. Provide feedback loop to clinicians and staff teams
    • Clinicians want to understand how they are being scored and where they have the best opportunities to improve
  4. Provide transparency
    • Communicating successful as well as failed efforts and the learnings accrued builds trust

E-Patient Update: The Kaiser Permanente Approach To Consumer Health IT, Second Stanza

Posted on July 7, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As some of you may recall, I recently wrote a positive review of Kaiser Permanente’s use of consumer-facing health IT. (Kaiser Permanente is both my health insurer and provider.) Their offerings have a number of strengths including:

  • Interfaces: The kp.org site is decent, and the KP app highly usable
  • Access to care: Booking medical appointments is easy, as is cancelling them
  • Responsiveness: Physicians are quick to replay to email via the Kaiser portal
  • Connectedness: Thanks to being on a shared Epic platform, every provider knows my history (at least for the time I’ve spent within the KP system, which is pretty useful)

At the time, I also noted that I had a few minor concerns about the portal features and whatnot, but I was still a fan of KP’s setup.

By and large, my perceptions of Kaiser’s consumer health IT strengths haven’t changed. However, after a couple of months in the system, I’ve gotten a good look at its weaknesses as well. And I thought you might be interested in the problems Kaiser faces in connecting consumers, particularly given its use of best practices in many cases.

All told, these weaknesses suggest that over more than ten years after its Epic rollout, KP leaders still haven’t put their entire consumer health IT strategy in place. Here are a couple of my concerns.

Specialist appointments aren’t integrated

The biggest gripe I have with Kaiser’s interactive tools is that while I can schedule PCP appointments myself, I haven’t been able to set specialist appointments without speaking to a real live person. (My primary care doctor seems to be able to access specialist schedules and set appointments with them on my behalf.)

This may work for someone with no significant health problems, but creates a significant burden for me. After all, as someone with multiple chronic illnesses, I schedule a lot of specialist consults. You don’t realize how much time it takes to set each appointment with a clerical person until you’ve done it for five times in a week.  Try it sometime.

You might assume that this is a rationing measure, as organizations like KP are pretty strict about limiting access to specialist care. The truth is, that doesn’t seem to be the case. At least when it comes to my primary care physician (a big shout out to my PCP, Dr. Jason Singh) it doesn’t seem to be unduly hard to get access to specialists when needed.

No, I have concluded that the reason I can’t schedule specialist appointments online is that KP still hasn’t gotten their act together on this front. My guess is that the specialist systems live in some kind of silo, one that KP hasn’t managed to break down yet.

Mobile and web tools clash

As noted above, I’m largely satisfied with both KP’s consumer portal and its mobile app. True, the website sprawls a bit when it comes to presenting static content — such as physician bios — but the portal itself works fine. The mobile app, meanwhile, is great to use, as it presents my choices clearly and uses screen real estate effectively.

That being said, it annoys the heck out of me that there are minor but seemingly pointless, differences between how the portal and the mobile app function. It would be one thing the app was a shrunken down version of the website, offering a parallel but more limited version of available functions, but that isn’t how it works.

Instead, the services accessible through the portal and via the mobile app vary in small but irritating ways. For example, when emailing providers, you must choose a prewritten subject line from a drop-down menu. And I don’t know why, but the list of subjects available on the web portal version varies significantly from the list of subjects you can access via the mobile app.

There may be a rational reason for this. And mine may sound like a petty objection. But when you’re trying to address something as important as your healthcare, you want to know what’s going on with every detail.

I’d identify other ways in which the app and website portal vary, but I don’t have any other examples I can recall. And that’s the whole point. You don’t remember how the site and/or portal function until you stumble into another incompatibility. You roll your eyes and move on, but you see them again and waste one more spark of energy being annoyed.

It’s all about tradeoffs

So, you might ask if there’s any broad lesson to be taken from this. Honestly, probably not. I don’t like that KP’s tools pose these problems, but they don’t strike me as unusual.

And do my criticisms have any meaning for other healthcare organizations? Nothing more than a reminder that patients will take note of even small problems in your health IT execution, particularly when it comes to tools they rely upon to get things done.

In the end, of course, it’s all about trade-offs, as with any other industry. I don’t know whether KP chose to prioritize a potentially dangerous problem in provider-facing technologies over consumer quibbles, or just don’t know what’s going on. Perhaps they know and have added the fix to a long list of pending projects, or perhaps they don’t have their act together.

Still, lest it is lost in the discussion, remember I’m the customer, and I really don’t care about your IT problems. I just want to have tools that work every time and simplify my life.

So this is my official challenges to Kaiser leadership. For Pete’s sake, KP, would you please help me cut down on the specialist phone calls? Perhaps you could create a centralized specialist appointment call center, or use carrier pigeons, or let me suss out their schedules using my vast psychic powers — hey, they’re all options. Or maybe, just maybe, you can let me schedule the appointments online. Your call.

A Health Reform We Can All Support

Posted on July 6, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

If you’re like most Americans, you have a pretty strong idea of where you stand in the debate over healthcare reform. This has always been a hot button issue, but now attempts to repeal or remake the terms of the Affordable Care Act have heated things up further.

Is there any strategy that can generate a bipartisan agreement on these issues? Well, maybe. Buried in a Washington Post article on bipartisan reform, there’s an idea you’ll probably like. Bear with me for a moment and I’ll explain.

The piece, which was written by Harvard economist David Cutler, notes that there’s a few industry problems that nearly everyone recognizes, including the need to address the opioid epidemic, the importance of trimming medical pricing and costs and adopting strategies to slash healthcare’s high levels of administrative spending.

Not to dis a Harvard professor too much, but most of his piece lacks specifics. OK, great, we get that you’ve identified some overarching problems the healthcare industry must address. That’s fine. What about doing something other than saying “This house is on fire. Get a bucket of water!”?

Such vague pronouncements are part of why reform is so difficult; few experts seem to be willing to get down in the weeds and explain just how execute on their proposals. The pundit-ocracy and professors and think tanks are looking at reform issues from the 10,000-foot level – and there’s merit in what they do. But providers are on the battlefield fighting for their lives, and theories don’t help them much.

Nonetheless, Cutler did list one cost-cutting measure that could actually be practical. He argues that developing uniform quality metrics all providers and health plans can use, as the current explosion of quality data demands is unsustainable.

Cutler argues that a government entity should manage the process of consolidating metrics, and even write regulations demanding that providers use the resulting standards. I, for one, think that this isn’t going to work, as the federal government doesn’t have a great track record in building consensus on health IT issues.

Still, if there’s a reasonable way to do so,  most providers would love, love, love to see somebody rid them of the hundreds of quality measures they must address and simplify the requirements to only those that actually impact quality. Who wants to deal with MACRA, Meaningful Use and its descendants, the Physician Quality Reporting System plus dozens of other data requirements? Hospitals and doctors are being quality-measured to death.

I know, I know, it seems unlikely that anyone could slash their way through thousands of standards and pick a winner. After all, the reason there are so many approaches is that no one is sure which one is best.

Can we at least agree that scaling back demands is critical? Yes? That’s progress. I’m not suggesting that there’s anything wrong with complaining non-stop about the quality metrics problem; in fact, given the burden these requirements impose, you’d be crazy not to protest. But it’s time to get real and figure out exactly what you want to do about the problem. Are you ready to demand change?

WorkFlow Wednesday: Patient Satisfaction and West’s Patient Experience Survey

Posted on July 5, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor. Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare. twitter: @coherencemed

Providers can improve patient experiences and revenue. So much of what improves satisfaction is outside the clinical setting.  West’s Insights and Impact Study titled “Prioritizing the Patient Experience” examines the gaps in patient value perception in the current healthcare marketplace.

West recently conducted a survey of patients providers to get more insights into what patients and providers value.  With value based payment models and consumer focused health providers are increasingly motivated to provide high quality service. Today’s patient is more aware of choice in provider options and will shop around for a provider that matches their needs.

Patients and Value Based Care Provide More Awareness of Choice in the Healthcare Marketplace

Patient experience using current technology and workflows is the space West has been working in for 25 years, including patient reminders for large hospital systems. As a company that specializes in patient experience, they used an outside firm to get insight about how well provider and patient perceptions were aligned. It was impressive to see an engagement company practicing what they preach and being proactive about feedback and improvement.

The most interesting takeaway from all of the statistics and research and report is that we know what the drivers of a good experience are. If you ask patients and providers what their motivation are answers are not usually aligned. This gap in what providers and patients value in terms of healthcare experience can cost providers revenue and patients. Patients value a high level of communication and transparency about cost of care more than providers believe.

Looking at the study, 78% of patients with a Chronic condition are likely to say that their provider cares about them as a person. Personally I’ve experienced this with my son that has a Chronic condition. We researched providers to ensure that we had similar values about communication and follow-up. Social Media groups like mom groups on Facebook have a lot of feedback about provider value. I know his provider gives great care and cares about him.

Patients with a Chronic Condition are Likely to Receive Personalized Care.

My Takeaways From the West Report

  • Current Systems do not always create a seamless workflow. Smooth workflow and patient communications improve patient experience.
  • Patients really want to know about what to expect in appointments. Sending a notification about costs including copays and obligations improves patient satisfaction.
  • Wait times are a huge cause of concern for patients. Electronic messaging or text information about waits can improve patient satisfaction even in cases where delays cannot be avoided.
  • Making payment as easy for patient as possible improves patient healthcare experience. A reminder about a bill with information about how to pay will improve practice revenue and patient experience.
  • Simple workflow improvement and automation improves clinical outcomes and patient retention in an increasingly consumer aware healthcare world.
  • Providers can focus on using the technology to better measure that for further strategy for improvement.

Well developed workflow can ensure that physicians have fewer patient surprises. Rather than waiting for an HCAP you can proactively collect data and brief surveys on specific topics before you are doing emergency triage. Contact recently discharged patients via an automated phone message or email. Have the questions tie back to HCAP survey questions so they can see what they will get.

What can systems do? Select Key measures for patient satisfaction.

What can physicians do? Tell patients that what to expect.

West is following their own advice and getting feedback about the value of communications and technology The survey is a connector for patients and for technology companies in the HealthIT space. Great ideas about Workflow improvement and best practice for business from West.

The report can be accessed online here and these key takeaways and is a great read for providers.

Happy Fourth of July

Posted on July 4, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I love the Fourth of July Holiday. We do a hike in the mountains to start the day and a big family party at night to end it. Should be a fun day. I hope everyone else enjoys the holiday as much as me. And to all those in healthcare that are still working on the holiday, we salute you!

I also love this picture to celebrate July 4th. I’ve been thinking a lot lately about finding joy in life and the pure joy of children. I’m not sure I have any great conclusions yet, but I definitely want to find more freedom to have joy in all parts of my life.