The three priorities of healthcare delivery — cost, quality, and access — need not be at odds with each other. Employers today are increasingly engaged in a range of innovative approaches to improve healthcare quality and control costs that directly address some of the underlying flaws in the system.
By using data-driven insights, employers are striving to nudge their employees towards higher value and efficient care, and away from potentially wasteful services. As employers make stepwise changes in implementing value-based care, they need to integrate a comprehensive Virtual Care Solution to address a range of conditions, including comorbidities.
Employers can improve employee health outcomes through care programs that utilize proven care protocols. They can reduce the total cost of care through interventions that reduce the likelihood of exacerbations that could result in Emergency Room (ER) utilization, surgery or inpatient stays.
But how do they close care gaps and manage the rising healthcare costs in the organization? What are the top drivers of rising healthcare spending for employers?
What are Gaps in Care?
A study revealed that the two main drivers of healthcare overspending are failure of care delivery and failure of care coordination. These failures are amplified when health care plans address high-risk patients with comorbidities.
“Gaps in care” refer to the discrepancies between recommended best practices in healthcare and the care provided to patients. These can manifest in several ways, including high-risk patients who fail to adhere to recommended screenings, their inability to follow the prescription guidelines, inaccessibility to the right care at the right time, and cases where the patient’s diagnosis isn’t shared with their PCP, to name a few.
These care gaps are a quality issue for both patients and payers like self-insured employers, and closing these gaps can help offer better health and wellness to employees and their families.
How does Virtual Care address these Gaps in Care?
Virtual care is the key to identifying and closing gaps in care. By evolving care management tools, employers can find out where there are opportunities for improvement in their benefits utilization and compliance with recommendations.
Employers can ensure compliance to benefit plans and reduce costs through three actions. First, they can use data- and analytics-supported targeted outreach to their employees. Second, they can integrate more real-time data into their plans to enable timely, personalized interventions. Finally, employers can support omni-channel communication to help expand access.
The same is the case with high-cost employees living with chronic conditions- earlier screening, preventive care, and compliance with recommended treatment procedures can improve health outcomes and enable tailored recommendations for employer-sponsored benefits.
Why Virtual Care?
Actionable insights that employers can use to close Gaps in Care
What can employers do once they identify gaps in care? There are several interventions that benefits consultants and self-insured employers can consider:
To learn how you can manage the growing burden of chronic conditions through a virtual care solution, get a demo.
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