In the News: Aug 15–22

Care Coordination Remains a Manual Process

A recent Fierce Healthcare article discusses a PointClickCare report regarding the inefficient methods of patient data sharing among acute and post-acute care facilities. According to this report, 36% of acute care providers use manual tactics such as fax, phone call or paper records to transition data to a post-acute care facility. Additionally, 62% of post-acute care centers report that they need to call case workers to gather clinical information about their patients.

Despite recent efforts to enhance coordination for patients throughout the care continuum, only a small portion of acute and post-acute care facilities share digital data. According to the report, 11% of acute care providers rely on an integrated electronic health record, and 2% of acute and post-acute providers use a common IT system to coordinate patient care. Moreover, 36% of acute care centers acknowledge that they do not monitor patients once they switch to a post-acute care setting. These obsolete practices increase the risk of clinical mistakes and redundancies, which can be costly for both the patient and provider.

Improving coordination beyond the acute care setting is a critical factor for providing low-cost, high-quality care. Creating initiatives that encourage complete integration across the System of CARE will help provider organizations shift toward the value-based care model of the future. To learn more about how to shift to an integrated care framework, please read the Sg2 report Continuing Care-Remapping the Post-Acute Path.

Frustrated Colorado Residents Contract Directly With Providers

With average emergency department claims at 842% of Medicare rates and outpatient rates at 505% higher than Medicare, residents of Summit county in Colorado came together to form Peak Health Alliance, as highlighted in a recent Kaiser Health News article. High costs incurred by tourists, skiers and other lovers of the outdoors have left residents frustrated and unable to afford health care. Peak Health Alliance directly contracted with St Anthony Summit Medical Center in Frisco, CO, expecting to offer premiums 20% lower than current rates.

Peak Health Alliance gathered price information from their all-payer claims database and other self-insured employers’ insurance plans to benchmark these data against Medicare claims. They found staggeringly high prices and brought this analysis to St Anthony’s leadership. Only 15% of St Anthony’s business comes from local residents, allowing Peak to receive a discount of about one-third off of the “list prices.”

With ever-increasing health costs, the commercial insurance segment continues to shrink. To address employer pain points and to capture commercial volumes, employer contracting may be a great solution, offering health systems an opportunity to cement relationships with employers. For in-depth insights into strategic considerations for various employer contracting options, please read the recent Sg2 report Employer Contracting: strategies for Netting commercial Revenue and Volumes.

Biobanking Drives Changes in Medical Therapies

A recent Forbes magazine article discusses the revolutionary impact of biobanking on the collections of biological materials and health information. Rapidly advancing biobanks are focusing on specimen and information collection that will lead to disease understanding, drug discovery and knowledge sharing. However, the capabilities of biobanking could extend beyond health care to industries such as agriculture and ecology.

By decentralizing data aggregation from individual laboratories and transitioning to biobanks with nationwide contributors, large amounts of human biological and genetic data can live in a communal space for the broader scientific community to access. This expanded access will support innovation and breakthrough therapies, including personalized medicine. In order to best support biobanking infrastructure and data, safety protocols must be put in place.

As biobanking continues to advance, health systems must continue to invest in technologic infrastructures and intensify their data use and sharing policies. Additionally, investment must be made around consumer education and compliance. To learn more about the latest technologic advances and how to advance your precision medicine strategy, please review the Sg2 webinar Precision Medicine Landscape 2019.

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