Connect to Minimize Risk and Maximize Reward
Providers will form business alliances with those who are easiest to connect with to ensure continuity of care and desired outcomes.
John Damgaard
3/1/2018
For many providers, 2017 was a roller coaster. In an industry that was already immersed in change as a result of the Affordable Care Act, the new administration promised even more turmoil. As a result, many providers held back from making technology investments as they sat back to see how the dust would settle.
However, as the year wore on, it became apparent that waiting wasn’t a viable option.
With constant reimbursement pressures, narrowing networks, and skilled worker shortages that will only get worse as many older, more experienced caregivers begin to leave the labor force, those who aren’t actively preparing for these changes will find that not deciding becomes a decision in itself—a decision to fail.
A Fork in the Road
This is because long term/post-acute care (LT/PAC) owners and operators are facing a very clear fork in the road: They can either assume and manage risk in care delivery or become a commoditized supplier. But regardless of which route they choose, there are certain technology “must-haves” that are required to accomplish either one effectively.
Those who understand that value-based care is here to stay, accept that risk and reward are inextricably linked, and envision themselves as more than a commodity supplier will choose the first fork. These are the profession’s true leaders. These leaders understand that clinical performance and the ability to seamlessly integrate into a connected health care system are essential to their future and to the brand promises of their companies. These organizations are not necessarily at the bleeding edge of technology, but they are progressive adopters who understand that people cannot meet tomorrow’s challenges with yesterday’s technology.
Pinpointing Success
When looking at those who excel in long term care, it’s hard to pinpoint what factors contribute to that success. Like any quality domain, clinical quality is driven by a combination of things. However, here’s a look at clinical quality from a Six Sigma perspective by applying the Define-Measure-Analyze-Implement-Control (DMAIC) process improvement cycle.
The mapping of processes and the relentless collection of process and outcomes data are always the starting point for true improvement and represent the “DM” part of the cycle.
With these data, robust analytics (the “A”) can be employed to isolate variances to the plan and determine root cause. Then, with a firm understanding of the root cause, the process or standard of care can be modified (the “I”) to drive out unwanted variances, and a control plan (the “C”) can be established to ensure compliance and monitor ongoing organizational performance.
Aiming for Clinical Excellence
The highest-performing organizations commit this type of continuous quality improvement not as a means to meet regulatory requirements, but as a true catalyst to clinical excellence. These leaders will deploy technology that supports this process, including:
- Analytics that allow decision makers to look across the entire enterprise to spot variances in near-real time. Mobile dashboards allow executives to pull up the relevant data on any device for informed decision making on the go.
- Clinical decision support that accommodates the unique workflows of each care setting, while driving consistency and best practices in care delivery, as well as enforcing compliance with necessary regulations and requirements across the organization.
- Care coordination tools that integrate information from both acute care and post-acute care providers, pharmacies, and therapists, as well as data from telehealth devices, while empowering the resident/patient and his or her family to be active participants in the senior’s wellness journey.
A Seamless Integration
This last point, the ability to seamlessly integrate into a connected health care system, is absolutely essential for preserving and enhancing patient/resident flow, for overall clinical performance, and ultimately for the operator’s success.
Managing risk of care delivery requires person-centric care that is built upon the understanding that those under care will, at times, require additional care outside of the facility’s walls or from another provider organization.
In this new, connected health care world, both upstream and downstream provider partners will continue to evolve and shift—but ultimately will choose to form business alliances with those who are easiest to connect with, so as to ensure continuity of care and desired outcomes.
Circling back to the initial fork in the road premise, LT/PAC providers need to make a choice. However, even those who choose the less profitable “commodity” route will find that strong clinical outcomes are still required to participate as a supplier to those who manage risk in care delivery. Hence, either fork taken will require providers to embrace the technology required to drive outcomes performance and continuous improvement within their organizations.
John Damgaard is president and chief executive officer of MatrixCare and president of the National Association for the Support of Long-Term Care (NASL). He can be reached at john.damgaard@matrixcare.com.