Emma Jones, 67 was diagnosed with Type-2 diabetes and morbid obesity five years ago and had always faced issues managing her HbA1c levels and morbid obesity. Her last test report revealed her HbA1c to be higher than the ideal and her obesity , barely controlled. Emma’s PCPs and specialists knew that the problem was related to her poor adherence to care plans and irregular follow-up visits. Apart from her wellness and health, the secondary concern for the providers was facing the growing emphasis Medicare had placed on overall performance and its link with reimbursements.
Care management in the era of Value-based reimbursement
The idea of care management has been primarily established in the healthcare space for years. With the growth of value-based incentives and risk-based contracting, healthcare providers have lately increased their focus on improving outcomes and ensure patients get the right care at the right time.
Value-based reimbursement models push providers to strive to provide the best care and offers rewards for improvements in outcomes, efficiency, and wellness in an evidence-based, cost-effective manner. Effective care management is an important tool that focuses on patient-centric care and generates a quantifiable ROI to contribute to a healthcare system’s bottom line.
What should care management entail?
In a nutshell, care management comprises of all the activities performed with the aim to improve patient care and helping caregivers manage health effectively post-discharge. Providers have lately started leveraging health IT to make the entire care management plan comprehensive and improve outcomes by a wide margin. Deep diving into it, a care management tool should entail following features:
The case for a multidisciplinary, coordinated approach
According to a survey, 44% of high-need patients face major coordination problems after being discharged from a facility. Moreover, no two patients pulled into a care management program would have the same needs. The care teams need a way for rightsizing every patient and employ a multidisciplinary approach:
Care management contributes to Population Health Management
Comprehensive, end-to-end care management undoubtedly has a significant impact on patients struggling with more than one medical condition. Health systems and organizations have begun to redesign their care management programs that address the struggles patients face and make care delivery a successful experience. Population health management is all about improving clinical and financial outcomes, and it is not possible without effective care management. Providers should aim to work towards that and leverage all the tools at their disposal to easily coordinate care for patients and improve their lives, one patient at a time. A complete care management model is what healthcare providers should employ to improve healthcare industry and population health as a whole and obtain better outcomes at lower cost, driven by value.
For more updates , Subscribe
If you want to see our efforts in the area , schedule a quick demo