Healthcare providers increasingly leverage population health management tools like RPM and CCM to improve outcomes and reduce costs. When combined with data analytics and patient engagement, these tools can also help shape a healthier future for everyone needing medical care.
Establish your goals and vision for the new software before contacting providers to request estimates. This will clarify what functionality you need the tool to have.
Data Analytics
The most effective population health management software solutions provide real-time healthcare improvement insight to clinicians and administrative staff. These systems feature tools for patient case management that support the goals of value-based care models, like accountable care organizations (ACOs). These tools offer workflows to help manage complex processes such as coordinating patient appointments with multiple providers and identifying appropriate support services. They also provide a digital repository to centralize data related to patients’ unique medical histories and disease profiles.
PHM software also includes risk stratification and care coordination tools, allowing healthcare professionals to identify high-risk patients who need additional attention and preventive treatment. Healthcare providers can use these tools to reduce hospital admissions and readmission rates, reducing costs for their organizations.
PHM systems can also help value-based payment initiatives like the Centers for Medicare & Medicaid Service Quality Payment Program succeed. They offer the analytics and data-driven methodologies essential to achieving success in these types of payments.
They can track the progress of clinical, financial, and operational outcomes and analyze these efforts’ impact on the community. These types of analytics are critical to supporting a successful ACO model, and the right population health management technologies can make all the difference in meeting your organization’s goals.
Automated Claims Adjudication
The best population health management tools will automatically process claims, reducing backlogs and improving workflow efficiency. This allows healthcare organizations to focus on the most critical aspects of their jobs, such as patient care and improving outcomes.
To choose the right tools for your organization, identify the critical requirements for each area you want to improve. Having these requirements documented will help you avoid unnecessary costs and ensure that the tools you implement will meet your needs.
Once you’ve identified your needs, you can look for vendors. However, developing a detailed project charter is essential before contacting vendors for quotes. This will help you define the scope of your project and ensure that all the stakeholders are on board with the goals of the implementation.
A reliable population health management system will allow you to track patient progress through care plans and alerts, helping your organization reduce readmission rates and achieve the Triple Aim of improving outcomes, lowering costs, and elevating the patient experience.
By using these tools, you can also prevent hospital admissions and readmissions by identifying and prioritizing patients who are at risk and may need extra care. Additionally, they will enable you to track cost-saving opportunities and identify trends that can be used to inform future decisions.
Patient Engagement
A good population health management software solution can ensure high patient engagement. This is important because patients who are active participants in their medical treatment have better health outcomes and experience. This is why healthcare organizations must make patient engagement a priority in their overall strategy.
This can be accomplished through digital tools that allow patients to access information and services and communicate with their healthcare providers.
Another critical feature of a good PHM solution is its ability to automate claims adjudication processes. This helps reduce backlogs and speeds up claim processing times. Additionally, it can help optimize workflows and ensure greater accountability in operations.
Choosing the right technology tools for managing your population’s health requires input from your organization’s leaders. This will ensure that the tools you select meet your organization’s requirements, are cost-effective, and align with your strategic plan. Additionally, it’s a good idea to develop a project charter that describes the goals of your initiative and outlines the steps necessary to achieve them.
Patient Tracking
The right PHM software solution helps you track patient health outcomes and performance to make informed care decisions. With advanced data analytics tools, you can identify gaps in preventive services and address them quickly. You can also improve follow-up between providers and eliminate unnecessary tests or duplicative testing. The result is better outcomes, higher satisfaction, and faster reimbursement from value-based contracting arrangements.
PHM tools can help you streamline your operations, which is essential when implementing new payment models. For instance, you must concentrate on patients with more complex diseases to comply with the Centers for Medicare & Medicaid Service (CMS) Quality Payment Program. A PHM tool can help you satisfy these requirements.
Before contacting vendors to discuss their products, develop detailed requirements and use those as your benchmarks. Ultimately, you want to determine whether the investment is financially viable. To do that, create a spreadsheet listing the necessary tools and their costs. Then, compare your spreadsheet results against the estimates provided by vendors to make a decision.
Conclusion
The tools should also be designed to deliver customized messages based on each patient’s specific needs. They should also be capable of capturing patient-generated health data (PGHD). This is useful because it allows healthcare providers to capture a comprehensive view of each patient’s health status and provide valuable information that can improve the quality of care.
