May 31 2022

5 Ways to Leverage Tech for Hospital Success Under Value-Based Care

To operate more effectively in value-based programs and achieve the Quadruple Aim, hospitals can focus on improving outcomes across five critical areas.

Incentivized by the Centers for Medicare & Medicaid Services (CMS) to transform care delivery to improve outcomes, healthcare stakeholders are increasingly turning to value-based care initiatives. Outcomes are now contingent on providers working together across the continuum for shared goals, but hospitals are often not equipped with the resources necessary to do so.

That’s where technology comes into play. To operate more effectively in value-based programs and achieve the Quadruple Aim, hospitals can utilize technology to improve outcomes across five critical, interconnected areas.

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1. Reduce Emergency Department Use With Digital Health Tech

In the U.S., 1 in 5 people visit the emergency department (ED) at least once each year, but two-thirds of these visits are avoidable. EDs are a costly place to receive nonemergent care, and knowing when to intervene before patient admission is crucial to reducing spending. Limiting the number of unnecessary admissions from the ED could save the U.S. $32 billion annually.

To drive down costs, care can often be provided in a less costly setting. Leveraging the right technology, hospitals gain better visibility when a patient arrives at the ED, ensuring the appropriate intervention to evaluate whether the patient can be treated in a primary care setting or even at home. Technology also loops in primary care providers and post-acute providers regarding shared patients, enabling them to “quarterback” patient care across the continuum.

2. Health Technology Can Reduce Hospital Admissions

The average hospital observation or inpatient stay costs between $8,000 and $23,000, respectively.

Hospitals should require technology that addresses patients’ social determinants of health to better manage the patient before they even reach the hospital. Technology can help connect patients with local home- and community-based organizations to better support their needs, such as food, housing, help with substance abuse and mental health, and reducing patients’ reliance on hospitals and EDs.

READ MORE: Learn how AI helps healthcare organizations reduce avoidable patient harm.

If a patient already has been admitted to the hospital, providers may also take steps to minimize the length of stay. In many cases, the potential need for post-acute care is identified upon admission. Patients, families and case managers are then tasked with finding a high-quality post-acute provider that’s geographically convenient, has bed availability, accepts their insurance, offers desired amenities and meets specific clinical needs.

When using technology to educate patients regarding available post-acute providers, information is efficiently delivered at the bedside to minimize avoidable discharge delays and to reduce acute length of stay and readmissions.

3. Identify the Appropriate Next Site of Care Post-Discharge

According to Penn Medicine researchers, “nearly 90 percent of Medicare patients discharged to post-acute care receive that care in either a skilled nursing facility or home healthcare.” But post-acute care costs vary greatly between the two.

Hospital referral patterns also vary greatly. While some health systems more frequently discharge patients to home healthcare, others primarily discharge patients to SNFs, even when those patients could be treated at home.

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Discussions regarding a patient’s post-acute care should be ongoing during a patient’s hospital stay, and technology can help support care decision-making by considering quality and outcomes of similar patients. This technology helps providers make the most appropriate decisions for their patients while also mitigating readmission risk and reducing potential post-acute care spending.

Getting the patient transitioned out of the hospital right means identifying the appropriate next site of care post-discharge and setting up the appropriate services in a timely manner to help ensure patients’ successful recovery when they go home. A smooth care transition drives improved clinical outcomes; results include fewer post-discharge adverse events, reduced readmission rates and use of appropriate services that directly lower the cost of care.

4. Optimize Skilled Nursing Facility Length of Stay

It’s incumbent upon providers to optimize a patient’s length of stay at an SNF, as SNFs represent a significant proportion of Medicare fee-for-service costs.

Using the appropriate technology, hospitals leverage real-time data on length of stay and benchmarks to identify a patient’s optimal post-acute length of stay and collaborate with the SNF to discharge the patient on time. In optimizing post-acute length of stay, hospitals can ensure a patient’s safe and successful discharge to the community.

5. Reduce Hospital Readmissions With Technology Implementation

ED diversion, avoiding unnecessary admissions, identifying the appropriate next level of care and optimizing SNF length of stay are all critical components to reducing hospital readmissions. Potentially avoidable readmissions cost Medicare $17 billion annually.

Hospitals are under increasing pressure to reduce readmissions to contain costs and succeed under value-based initiatives such as CMS’ Hospital Readmissions Reduction Program (HRRP), which penalizes hospitals with relatively higher rates of Medicare readmissions.

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The transition from the hospital to a post-acute care facility is one of the most challenging junctures in the patient journey: Nearly 23 percent of SNF patients are readmitted to the hospital within 30 days. Patients discharged from post-acute care often turn to the ED because of inefficiencies earlier in the care transition process, such as a mismatch between patient needs and post-acute care facility resources.

Readmission is an adverse outcomes for both the patient and the provider, but there are multiple opportunities to positively impact hospital readmissions throughout the patient journey. To effect real change, providers require technology that brings together all stakeholders on a singular platform where they can place patients with high-quality providers, monitor high-risk cohorts, obtain visibility into the start of a home healthcare episode and identify value-based patients early to follow through the episode.

Break Down the Health Technology Silos

Technology is a key driver behind achieving true value-based care. It has the power to break down silos, connect provider workflows, increase efficiencies and share insights into the patient journey. Providers experience increased communication, enhanced transparency and better alignment on key metrics with other cross-continuum stakeholders, all helping to transform healthcare delivery and reward stakeholders based on outcomes.

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