6007 – Post-Discharge Engagement: The Key to Success in Value Based Purchasing
Public and private sector payers continue to look to value-based purchasing and alternative payment models to reduce healthcare costs while improving quality. These models aim to shift payment from reimbursing for specific services to supporting providers in delivering high quality care, reducing fragmentation across the system, and promoting cost efficiency. Increasingly, success in these programs is being measure by the patient’s outcomes. However, healthcare is only one factor that influences a person’s health. A person’s behaviors and social and environmental factors can also significantly affect their health outcomes.
The key to successfully tackling these forces lies in the healthcare system’s ability to engage and assist patients in the post-discharge space. Specifically, case managers have an essential role to play in improving care transitions and helping people engage in successful self-care. Clients are underutilized members of the care team even though over 60% truly want to comply with their after-care plan but face extrinsic barriers (e.g. knowledge deficit, financial resources, housing, food, and transportation). Technology offers case managers innovative ways to engage with clients and understand their social and healthcare needs in real time. This can facilitate better conversations between the client and the case manager, allow the individual to be more involved in their care, promote higher quality care transitions, and ultimately, improve patient outcomes by addressing their needs, ensuring understanding and acceptance of their care plan, and reducing the need for higher acuity care. Additionally, the healthcare system simply does not have enough case managers. Technology, especially predictive analytics, allows case managers to spend the most time with the right patients at the right time.