Health Systems Enter 2020 Ready to Embrace Advanced Technologies and Reap the Benefits

The healthcare industry has traditionally had difficulty implementing new technologies for numerous reasons. Questions of reliability, regulatory hurdles, and prohibitive costs have made many technological innovations unavailable for all but the most prestigious institutions. As we move forward into 2020, however, it is likely that a culture of innovation and adoption will create the inflection point needed to catalyze the adoption of state-of-the-art analytics solutions. Health systems recognize the potential of new technologies, such as AI-driven prescriptive analytics, to augment the care that they provide. “Data science will increasingly guide clinicians in finding opportunities for improvement, designing and implementing interventions, and evaluating impacts” (Eddy, 2020, ¶3), and patients stand to reap significant benefits.

 

Takeaways

  1. Shifting the overall focus of care management programs from the most critically ill patients to a more holistic view of a population can reduce the number of “critical patients” in the long run. By utilizing both predictive and prescriptive analytics, providers can identify and address conditions that may cause more serious issues for a patient later on, potentially eliminating the need for serious interventions such as surgical procedures. “AI-driven prescriptive analytics and other advanced analytical techniques can process what can easily be 1,000 or more predictors from claims, self-reported consumer data, electronic health records, census, and social determinant data” (Eddy, 2020, ¶4).
  2. Prescriptive analytics is more accessible than ever, and data related to cost savings associated with prescriptive analytics is readily available. The high costs associated with implementation and staffing that oftentimes came along with technological innovations have shrunk considerably, but even in cases where “smaller organizations won’t seem to have the budgets allocated for predictive and prescriptive analytics…the ROI speaks for itself” (Eddy, 2020, ¶13). The precise nature of prescriptive analytics allows for better-tailored care plans that increase patient success. “Robust analytics can help organizations achieve triple aim by improving healthcare outcomes, reducing cost and improving quality. All in all, this can improve medical loss ratio for risk-taking entities” (Eddy, 2020, ¶15).

 

Innovista Health Solutions is dedicated to facilitating strong outcomes for patients through our care management programs. Dedicated team members work tirelessly to connect primary care providers, specialists, health plans, and patients’ support systems to limit avoidable visits to the emergency department and ensure consistent, accessible care. As noted by Pam Audish, Vice President of Medical Management, Corporate at Innovista, in her article for CMSA Today, Case Management in Primary Care Makes a Difference,“case management in primary care can reduce hospitalization, decrease healthcare costs, and improve physician and patient satisfaction” (Audish, 20).

Recently, Innovista has employed a combination of clinical patient data and data related to social determinants of health to determine which patients could benefit most from enrollment in a care management program. Our stratification model utilizes a rules-based scoring tool that groups patients into three categories: low, medium, and high, with patients grouped into the “High” category enrolled in a care management program. These programs were designed to ensure steps were taken to provide those patients with care interventions that were likely to improve their overall health, ultimately lowering costs, as well.

 

 

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About Innovista

Innovista Health Solutions exists to help providers succeed in value-based care by developing strong relationships, delivering innovative solutions and driving exceptional performance. Strong dedication to improving patient outcomes drives Innovista to provide partner physicians with expert staffing, clinical programs, delegated services, and analytics capabilities optimized to drive effective change.

 

Innovista Media Contact

Laura Bingham

lbingham@innovista-health.com