Analytics Will Drive New Care Models

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Karen Utterback By Karen Utterback 
Vice President, Product Management and Marketing, McKesson

Home Health Software AnalyticsThe success (or failure) of accountable care and other care and payment reforms can’t be determined without robust data and analytics, conclude the presenters of a recent McKesson webinar on accountable care.

“Provider analysis brings us closer to care delivery,” says Sheila Miller, director of Product Management Performance Analytics at McKesson. “By linking encounter data, organizations can identify variances in care, determine which processes work where, and pinpoint where they might break down.”

Linking providers across a care continuum through technology allows analysis that can identify and reduce or remove excessive costs. Specifically in the home health field, agencies can monitor populations by demographics such as ZIP code and age group, chronic conditions and socioeconomic circumstances to determine the interventions that might have the maximum impact.

At the point of care, home health software can enable checklists, evidence-based care and sequencing that can lead to higher quality care. Miller relates an anecdote from a McKesson client that helped post-hip replacement patients rehab at home rather than in a pricier skilled nursing facility. Home care service costs were higher for each episode of hip-replacement rehab episode but less overall than the higher-acuity center. Patient satisfaction scores were higher when care was delivered in the home.

“On the provider side, encounter and claims data and information on alternative care settings serve as the basis for regulatory reporting and reporting for care collaboration and coordination,” Miller says.

Fully leveraging the technology that will help agencies meet regulatory guidelines also can help alleviate the wide variation of care spending across the country, notes Bruce Haupt, vice president, Business Development at McKesson. Research from the Dartmouth Institute for Health Policy and Clinical Practice shows a three-fold variation in per-capita Medicare spending—with no correlation to the quality of care received.

The “traditional” model of healthcare is a series of silos, with a patient moving among a primary care physician, specialty physicians, hospital, post-acute care facility, homecare and other providers with little regard to where the patient came from and where she is going next.

In accountable care models, a group of providers is responsible for the health and well-being of a defined population. Coordination among providers is vital to meet each patient where he or she is, delivering appropriate, evidence-based care in the lowest-cost care setting.

Accountable care brings the need for new reimbursement methodologies beyond fee-for-service or episode payments. Technology and analytics become vital in this new care environment, Haupt says.

“Analytics allow providers to drill down to specific patients, specific providers and correlate cost and quality in an appropriate way,” Haupt says. “It closes the loop on population management.”

“Accountable Care: Measures of Success” was the third in a webinar series on accountable care. Listen to this and the other two webinars in the ACO series.

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