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Strategies-ACOs-use-for-better-patient-outcomes-and-lower-costs-RightPatient

Seven strategies ACOs use for better patient outcomes and lower costs

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According to recent studies, it is expected that Medicare’s projected spending will be well over $1.5 trillion by the year 2028 – that is more than double what the value was just two years ago! All Medicare asks from ACOs are better patient outcomes.

Many ACOs have already reduced costs and thus saved Medicare approximately $1 billion during 2013-2015. Not only did they reduce costs, but they also improved quality across the majority of the metrics required by Medicare. These exemplary ACOs depended on primary care visits, which they used to reduce ER visits and in turn, cut costs by around $700 per patient. 

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RightPatient enhances patient outcomes.

Some of the strategies which ACOs can follow to improve their healthcare spending patterns and generate better patient outcomes are: 

Collaborate with the physicians they work with

ACOs highlighted the fact that one of the ways to enhance the quality of healthcare as well as reduce the costs was to work closely with the assigned physicians. They also stated that these physicians are usually ordering services like lab tests for the patients or referring to other specialists without keeping the costs in check, and may inadvertently end up incurring more costs than necessary. However, if the physicians and ACOs collaborated frequently, the former can make informed decisions regarding the costs which will be beneficial for both the patients as well as the ACOs by reducing costs while keeping quality in check. Other than that, the physicians have to be busy with administrative issues, which can be quite hectic for them, which causes them to focus more on these tedious tasks rather than focusing on the patients. ACOs can collaborate with the physicians regarding these issues, as well, to reduce the time spent on such matters and focus more on the patients instead.

Encourage the patients to take initiatives regarding their health

A common yet effective strategy used not only by ACOs but by any health system is to encourage their patients to take charge of their health and adopt a better, more active lifestyle. However, ACOs are reporting that this can be quite challenging, especially if there are multiple physicians which is common in ACOs. What ACOs can do is adopt the strategy used by conventional health systems – use patient engagement apps like CircleCare. It has all the necessary features required for active patient engagement. Patients can track not only their steps but also keep track of their blood pressure, blood glucose level, schedule medicine reminders, and so on. It helps patients to maintain even the most complex medication routines as well as encourages them to lead a healthier lifestyle. However, these are not the only features of such apps, as will be explored further down the line.

Emphasize on patients requiring extra care

Care coordinators are professionals who are entrusted to make sure that the patients requiring extra care receive it, especially when they are discharged along with their proper medication as well as necessary materials. Nearly all the ACOs utilize such personnel who even help schedule follow-ups. However, ACOs can also use CircleCare in this context for better care, since these apps help patients and these caregivers to stay connected and exchange health information easily, perhaps about minor complications and so on. 

Reduce ER visits and readmission rates

Most ACOs face the problems of ER (emergency room) visits which in turn generate hospital readmissions, many of which are preventable. However, it is notably more of a concern for ACOs since they are fined based on the readmission rates. One strategy ACOs can use is providing digital solutions to patients such as patient engagement apps like CircleCare. Since these apps push the patients to be physically active, these can create better patient outcomes – the more active the patient, the healthier they will be. Also, since these apps have two-way communication facilities, they can contact their physicians regarding any minor health issues and resolve them outside the ACO premises, thus, reducing ER visits.

Enhance patient identification and data sharing

Patient identification is one of the major problems of the US healthcare system, and it is a massive concern for ACOs as well – they need to share patient data among themselves, and the data needs to be as immaculate and consistent as possible. Thus, ACOs can overcome the issues with conventional EHRs by using biometric patient identification solutions like RightPatient. It uses iris scanning to accurately identify the patients and match them with their appropriate records within seconds. This will improve the match rates as well as enhance the patient experience along with data sharing, which are all must-have features for any ACO as these lead to better patient outcomes.

Make sure medication adherence among patients is present

According to statistics, two-thirds of the prescribed patients are non-adherent regarding their medications. This generates 50% of treatment failures, causing up to 125,000 preventable deaths per year in the US. These could have been prevented if the patients were adherent to their medications, and for that, CircleCare is the perfect solution. Its medicine reminder makes medication adherence as easy as it gets – the patients using the app can set the type, color, look, frequency, dosage, starting/ending date, and duration through an intuitive yet simple interface. Even the most complex regimens become manageable due to CircleCare, ensuring medication adherence and thus fewer ER visits for ACOs.

Ensure patient education is provided

Patient education is another problem which generates frequent ER visits as well as hospital readmissions. Most patients have minimal knowledge regarding their health – 50% of them experience difficulty in understanding as well as using health information and 40% of them do not remember most of the information in the first place. CircleCare provides meaningful and easy to understand information for patients, customized according to their health conditions so that they can receive the latest knowledge regarding their health and make informed decisions if required. Moreover, it also provides general health tips regarding food and physical activities, which can help patients follow those tips for a better lifestyle and better patient outcomes.

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Patient engagement apps are reducing hospital readmission rates

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According to a recent study, patient engagement technologies like patient retention apps are more likely to lead towards better healthcare outcomes. Patients who used these apps contributed to reducing hospital readmission rates compared to those patients who did not use engagement apps.

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Patient engagement technologies like CircleCare, a patient retention app, have shown that they aid patients having chronic diseases to visit their healthcare providers more prudently. Rather than going to the EDs (emergency departments of their hospitals and spending a significant amount of money which could be preventable, they used these patient engagement technologies to take care of themselves and also contact their physicians whenever required, regarding their health updates and asking for assistance directly within the app. The latter is much more desirable as it saves money from a preventable hospitalization and where the patients have tools provided by their healthcare providers, thus, reducing hospital readmission rates. 

According to the study, patients suffering from chronic conditions face some challenges getting a cohesive healthcare service- they need to go through several primary and supporting facilities for the full experience, thus are bombarded with different data points and care sites, which result in a disrupted and broken healthcare experience.

The research also showed that tools which provide the patients with facilities like access to their health information, tracking their activities, are helping to deliver superior quality healthcare and help the patients to stay on track regarding their post-discharge guidelines, all of which leads to only better patient outcomes.

Patient engagement tools and better patient outcomes are positively correlated- the more the use of these tools like CircleCare, the more active participation is seen from the patients, and thus, the better are the patient outcomes as hospital readmissions are fewer for these engaged patients. Even if the patients had multiple diseases, as long as they had access to the tools and were using them actively, the research showed these patients contributed to reducing hospital readmission rates. 

The research was carried out by grouping patients by their chronic conditions, hypertension, diabetes, asthma, and so on. As previously mentioned, patients with chronic or complicated cases who had access to patient engagement tools were readmitted fewer times compared to those who did not have access or did not use it. 

These results show that patients are becoming health conscious than ever and are opening up to useful patient engagement tools. It is a positive outcome overall, as the patients are choosing to pursue an active and healthy lifestyle and not resort to hospital readmissions, which can be expensive and inconvenient. The study also demonstrated that unless it is too severe, the patients choose to communicate with their physicians via the engagement tools instead of opting for readmissions or similar actions. This way, they can talk about any discomfort or situations they are facing and get instant advice, which helps them save a trip to the ED. Thus, patient engagement tools are taking healthcare out of hospitals and making it accessible via mobile devices, which is very much convenient for the patients themselves. 

So, what are these patient engagement tools that are pushing healthcare to better heights? One of the prime examples is CircleCare, a patient retention app which doubles as a patient engagement app. It has all the features of a perfect patient engagement tool. CircleCare can track steps, schedule medicines reminders, record glucose level, blood pressure, and also provide a community where the patients can engage with one another for exchanging health tips- a social media for patients. Moreover, it is also a means for patients to communicate with their healthcare providers; thus, they can contact them whenever necessary, without any hassle. Once a hospital registers to the service, they direct their patients to download the app to their smartphones/tablets and register as their patients, and that’s it! Patient engagement tools like CircleCare not only help the patients to communicate with their physicians but also help them lead and maintain a healthy and active lifestyle, which in turn generates improved patient outcomes and results in reducing hospital readmission rates, making it a must-have engagement tool.

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Patient engagement is the key to improved patient outcomes

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Why might any healthcare provider contact their patients after their discharge? It’s simple – to encourage patient engagement so that the patients can be proactive and thus healthier, which in turn causes improved patient outcomes and lowers readmission rates, simultaneously reducing costs

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There’s a catch to this – if it’s so easy, why is effective patient engagement still out of reach for most healthcare providers? Let’s analyze.

A recent survey consisting of several healthcare systems sheds light on some interesting facts – 70% of the participants stated that less than half of their patients are involved in engagement activities, whereas a mere 9% said that they observe more than 75% effective patient engagement. 

Why are some successful and some unfortunate? It mostly reflects the fact that many are still confused by what patient engagement means. Many think that patient engagement refers to just giving a patient a scheduled time and making sure they know the patient’s name, and that’s all – but that is a far cry from what patient engagement entails.

Patient engagement refers to the healthcare provider learning about the patient’s interests, medical records, background, and anything relevant that is there to know about the patient as much as possible. What do the healthcare systems do with such data? They provide customizable tools to the patients which can be used for active patient engagement – to ensure improved patient outcomes and experience. There are many tools already available at the disposal of the healthcare providers to use for active patient engagement like CircleCare. Thus, patient engagement means providing a patient with tools and facilities which the patient can then use or participate in, if he/she chooses, to ensure better health and lead a healthier lifestyle, with its primary goal being improved patient outcomes and better patient retention rates.

Even large and reputed healthcare systems sometimes need the assistance of such tools for patient engagement, which is reflected in the survey’s findings. There are many examples that tell the same story repeatedly – a reputed healthcare system thinking that it was providing entirely satisfactory patient engagement until it started looking at the results and then teaming up with an external party who understands patient engagement better, and later on, the healthcare system actually seeing marked improvements because of using the new tools.

With the extensive knowledge and technical know-how of such third parties regarding patient engagement technologies, these healthcare providers saw that instead of using conventional facilities like patient portals, which can be clunky, unresponsive, and tedious to use, the patients used tools like apps which are available for both tablets and smartphones. The patients not only use it for better health and checking their records, but they also use it to communicate with their providers, exchanging crucial information, if required.

According to a healthcare official, patient engagement is very integral to their services, and they need it to ensure they have a healthy, mutually beneficial relationship with their patients. Such tools like CircleCare provide the window to ensure active engagement. Using CircleCare, patients can easily communicate with their doctors to let them know of any discomfort or updates in real-time. 

CircleCare is a patient retention app which doubles as a patient engagement app. It ensures maximum patient engagement, as it has features like tracking steps, recording blood glucose level, recording blood pressure, and also scheduling and reminding one about medicine. Not only that, it has all the features previously mentioned above, like communicating with physicians, exchanging information in real-time, and so on. Best of all, if the patient maintains an active, healthy lifestyle, which is shown as the patient completes “goals” and earns points within the app, they can also win exciting prizes which they can exchange with the coins. Once a healthcare provider subscribes to the app, they can direct the patient to download and use them for active patient engagement, ensuring lower patient readmission rates due to positive outcomes. 

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Can hospitals achieve better patient outcomes through patient engagement tools?

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Let’s face it – no patient thinks about going home and logging into a web portal. It is ancient at this point. During a recent event focusing on all things related to healthcare improvement, that was the opinion shared by a respected healthcare official. The rest of the executives from different healthcare systems who were participating with him nodded in agreement. On the contrary, they laughed, because they are accepting the fact that patient portals are just not practical. Not only for this small group of officials but by now, it is common knowledge that such patient portals did not turn out to be one of the effective patient engagement tools as they were once hoped to be. Where did it go wrong? What’s next? If this didn’t push patient engagement, what kind of patient engagement tool will? These are the questions on the minds making up the healthcare system.

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During the event, the group sat down and had a lengthy discussion regarding healthcare and patient engagement tools, and the following are some of the critical things that were revealed.

Patient engagement is of utmost importance

This was stated by all of the executives present. Patient engagement is one of the top three organizational objectives for them. They also believe the fact that their organization’s value patient engagement as they see patients who are more participative to have better health outcomes than those who don’t, along with increased satisfaction, retention, and revenue.

Priorities are not reflected in the results

Another notable finding during this discussion was that there is a massive difference between the amount of importance healthcare systems place on patient engagement and the level of results they deem successful – they interpret 15% as a good number. One may then ask, how can such a vast difference between objectives and results be possible? One official from a healthcare system said that they need to be completely digital regarding everything being done in their hospital – from the moment the patient decides to use their services until the follow-ups are complete. Naturally, they require a patient portal which the healthcare providers have, and they observe approximately 15% of patient engagement through it, which they believe is more than an acceptable number.

Even though considering such a small number as success is very peculiar, it is not uncommon. The Office of the National Coordinator for Health Information Technology states that less than one-third of the patients who had access to portals used it only one or two times per year. The ones who did not use the portals had a variety of reasons – they wanted to speak with their healthcare providers directly, did not deem it necessary enough to view their records online, were worried about the safety and privacy of the portals, or could not use them due to various issues.

Not enough advancements in patient engagement tools

The healthcare officials who were present in the event think that the motivation for effective patient engagement needs to come from the patients themselves. However, as the findings specified already, it is not always in the hands of the patients themselves, but in the hands of the healthcare providers – the latter are the ones who develop the patient engagement tools, strategies, and technologies to support them. For instance, no matter how participative a patient is willing to be, he/she will not be able to effectively engage with the healthcare provider if the patient portal is complex, faulty, or inefficient. Another drawback the officials stated was the perception of patients regarding the portals’ contents and features – if they were inconsistent and irrelevant, patients would not use them.

 Another official added that even though patient engagement is a top priority for any healthcare system, the ones running them do not utilize the tools available to make better use of technology and come up with something more innovative and productive than patient portals. They do not invest in the necessary places and do not hire the people who can bring about a change to patient engagement tools.

Is patient engagement actually possible?

Yes, of course. Patient portals may be clunky, complicated, and the fact that people use their browsers less nowadays does not help the matter. No, the solution lies somewhere else. People are always on their phones using apps, and this is the key – a patient engagement app like CircleCare. The patients do not need to go to browsers and sign in; all they need to do is unlock their phones and tap on the app – they are in! CircleCare is an app which helps the patient stay fit – it can track their steps, schedule alerts for their medicine, and record their blood glucose level as well as their blood pressure, thus, helping them to stay proactive and maintain a healthy lifestyle. Not only that, but the app also connects the patients with their physicians so that they can communicate with each other whenever required – to share critical information, updates, tips, and additional information regarding their health can be exchanged. Once the hospital subscribes to the app, all the patients need to do is download it and use it, which will not only help them maintain a healthy lifestyle, but also ensure active patient engagement, and as a result, hospital readmission rates will go down due to better patient outcomes and active patient engagement.

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How patient engagement solutions benefit physicians

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The number of patients who seek treatments for their ailments at retail clinics is continuously increasing. Also, mid-level staff and nurse practitioners are getting the chance to handle everyday clinical care. These may indicate that primary care physicians have lessened pressure, but the reality is entirely the opposite – they have to handle an unprecedented level of stress. So, where do patient engagement solutions fit in? Let’s analyze.

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These summaries were found after conducting a study. It included information from medical bills as well as relevant EHR data, where 4900 primary care practices were visited by 5 million patients 40 million times. This study found primarily two things in its duration:

  • 6% increase in average work performed was witnessed during each visit
  • 10% increase in the average number of recorded diagnoses each visit

However, some may be skeptical and think that these numbers are inflated, saying the sample healthcare providers may have meddled with the recorded data due to requirements of Medicare rules and contracts which are risk-based. On the other hand, the more optimistic people feel that primary physicians are working harder per patient, and their reasoning is simple – these physicians are handling the more complex cases because the easier ones are being pushed out to others.

A healthcare official from a renowned hospital has stated the same – the patients with less severe cases, like a running nose, go to the nearest clinics, whereas the complicated cases have insurance and thus line up for primary physicians. The official explained that the patients they treat are the ones with complex health issues like diabetes, hypertension, and heart failure, as well as depression, and even if they come with a small problem, they need to keep these other complex diseases in mind while treating them. Thus, the more complex the situation and the condition, the more tests and consultations are required.

Usually, such pressure can cause burnout within the physicians, that too without the help of patient engagement solutions which may have eased their situations. Conversely, many feel that they actually enjoy those patients who need their care and this makes such stress worth it. Nevertheless, they do not enjoy switching from complex to uncomplicated patients repeatedly, as it disrupts their workflow.

Also, even if these primary physicians are not handling the more uncomplicated cases, they still need to review some of them and participate in the decision-making process. Thus, the primary care physicians have a lot on their plates, and all of this creates dissatisfaction, burnout, turnover, early retirement – all of which is undesirable by the healthcare industry.

What can be done to reduce this stress? To keep the physicians more involved and engaged with their patients, the healthcare systems can use patient engagement solutions like CircleCare. This app helps the physicians to be in contact with the more complex patients once they are discharged, and both parties can provide essential updates to each other. The physician can also offer advice for small ailments the patients face. On the other hand, the patients will be able to record their blood glucose level, blood pressure, track their steps, schedule medicine, and so on. These features will not only help the patients to maintain their health but also provide this data to the physicians whenever required without hassle, thus providing motivation to these hardworking physicians for achieving better patient outcomes. Once the hospital is registered with the service, the patient only needs to download the app, and he/she’s connected with the healthcare provider and the physician for engagement, which will help to keep them healthy, and thus increase the patient retention rate.

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Ways in which patient engagement strategies prevent hospital readmission

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One of the main determinants of performance in the healthcare industry is reducing hospital readmission. In layman’s terms, it means that the lower the hospital readmission rate, the better the services are of the healthcare system. Many healthcare systems are trying their best to lower their readmission rates to save costs as well.

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Hospital Readmission Reduction Program (HRRP) was introduced by CMS in 2010 to deal with reducing hospital readmission rates. It has been successful, as it has helped to reduce readmissions by 8 percent.

On the surface, it might sound good and relatively easy. However, reducing hospital readmissions can be quite a challenge as it depends on several factors. Other than providing first-class care to the patients, the healthcare systems must also ensure the patients engage in post-discharge care management so that their condition becomes better, not worse.

How do the healthcare systems do that exactly?

Highlighting high-risk patients

During the post-discharge period, there are a lot of probable patients who might suffer from a medical issue. After identifying them, the task is to focus the engagement efforts towards these high-risk individuals. To determine the high-risk patients, the clinician can start looking at the healthcare conditions, which cause the highest readmissions. For instance, pneumonia, which is not caused by STIs or tuberculosis, causes 88,800 readmissions.

Not only medical conditions, but there are also other factors which can cause readmissions. Patients may have limited knowledge regarding specific topics. They may have limited health literacy, limited language skills, others may receive different information from different officials in the same healthcare system, and others can even be omitted from post-discharge care.

Patients can also be at risk of readmission if they are facing particular social determinants of health (SDOH). For instance, transportation issues, job security, and similar issues may prevent the patient from following up with the clinicians, which in turn will cause adverse health effects and thus readmission. Likewise, low earners will not be able to afford home care following the discharge.

The healthcare systems need to create follow-up procedures based on the above situations. By engaging with both the patients and their families and keeping in mind the SDOH, hospitals not only can make their follow-up strategies better but also help reducing hospital readmission.

Another solution to all these problems can be CircleCare patient retention app. It can provide essential health tips to the patients, keep track of their steps, maintain their medicine schedules, and also be a medium of communication with the hospital. After the hospital subscribes to CircleCare, the patients only need to download the app to use these benefits, which can help reducing hospital readmission significantly.

Engaging both patients and their family members

In the recovery phase, it is best to involve and engage not only the patients themselves but also their family members. This will help as the family members are aware of the patient’s preferences and thus can make him/her feel more comfortable as well as follow the instructions of the hospitals. This helps reduce the readmission rate by 25 percent for 90-day readmissions and 24 percent for 180-day readmissions.

Also, it is an excellent strategy to provide the guidelines in writing during the patient’s discharge, as it gives a detailed description for the patient to follow post-discharge. Statistics support this, as patients who were not provided with any detailed guidelines had 24 percent more chance to be readmitted.

Acknowledgment of SDOH

No matter the strategies, some patients may not be able to comply with the post-discharge and follow-up guidelines, which may not even be there fault. The SDOH can act as a barrier to their betterment.

According to Health Services Research, if the SDOH were factored into the HRRP, 21.8 percent penalty reduction would take place.

SDOH is not considered in the HRRP. The hospitals can provide questionnaires to the patients or their family members to find out whether they face any of the SDOH or some other barrier while availing post-discharge healthcare and follow-ups.

CircleCare

As there are various problems which might be faced by the patients – SDOH, lack of written instructions, or others, the best possible solution would be to give them something which they can access according to their convenience. CircleCare can not only engage the patients, but also keep track of their information like blood glucose, blood pressure, and remind them of their medicine intake. It also provides the patients with health tips and rewards and can be used to provide detailed instructions post-discharge as well as share health updates with the hospitals. All this will not only help improve the health of the patients, but it will also be a platform where the patients can be more engaged with the hospital by sharing their health-related statistics so that the officials can provide proper feedback. This, in turn, will cause patient satisfaction to rise, and ultimately, patient retention will be achieved.