Care Management Part 2 - A Critical Component of Effective Population Health
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Care management plays a central role in the world of value-based reimbursements, at-risk contracts, and population health management. Such programs require high-touch and resource-intensive care as teams work to deliver on the substantial promise of delivering patient care improvements while reducing costs.
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Care Management Part 2 - A Critical Component of Effective Population Health
- 1. Care Management (Part 2) Critical Component of Effective Population Health Management Kathleen Clary, RN, MN, DNP, FACHE
- 2. © 2016 Health Catalyst Proprietary and Confidential Agenda 2 Critical components of care management. How data and analytics can help. Return on investment.
- 3. © 2016 Health Catalyst Proprietary and Confidential Case Management Improves Margin 3 To have any hope of reining in health care spending, health systems need to actively manage care for their highest-cost patients. - The Advisory Board, How to Prioritize Population Health Interventions Margin by Risk Management Level*
- 4. © 2016 Health Catalyst Proprietary and Confidential Fee-For-Service to Value 4
- 5. © 2016 Health Catalyst Proprietary and Confidential Participation in Value-Based Payments 5
- 6. © 2016 Health Catalyst Proprietary and Confidential Population Health 6
- 7. © 2016 Health Catalyst Proprietary and Confidential Program Level Care Team Level Patient Level Ongoing care team input throughout the process Assess Problem(s) & Develop Care Plan Support the Plan & Coordinate Care Evaluate & Revise the Care Plan Patient Engagement Identify Patients Evaluate & Improve Program Enroll & Engage Care Management Process
- 8. © 2016 Health Catalyst Proprietary and Confidential Components of a well-organized care management program 8 Data Integration Patient Identification Care Planning and Coordination Patient Engagement Performance Measurement and Reporting EDW Patient Stratification Patient Intake Care Coordination Care Companion Care Team Insights Technical Team Chief Medical Officer Care Management Program Administrator Care Managers, Social Workers Patients Chief Medical Officer
- 9. © 2016 Health Catalyst Proprietary and Confidential Population Health/Care Management Team 9 Technical Team Chief Medical Officer Care Management Program Administrator Mini Strator Care Manager RN Jim Demor Patient Monica Wheat
- 10. © 2016 Health Catalyst Proprietary and Confidential10 How will you identify the patients who most need care management?
- 11. © 2016 Health Catalyst Proprietary and Confidential Poll Question #1 11 How effective are the algorithms your organization uses to risk stratify patients? 92 respondents a) Not at all effective – 7% b) Moderately effective – 33% c) Very effective – 8% d) We don’t use risk stratification algorithms – 22% e) Unsure or not applicable – 30%
- 12. © 2016 Health Catalyst Proprietary and Confidential12
- 13. © 2016 Health Catalyst Proprietary and Confidential13
- 14. © 2016 Health Catalyst Proprietary and Confidential14
- 15. © 2016 Health Catalyst Proprietary and Confidential15
- 16. © 2016 Health Catalyst Proprietary and Confidential16
- 17. © 2016 Health Catalyst Proprietary and Confidential17
- 18. © 2016 Health Catalyst Proprietary and Confidential18
- 19. © 2016 Health Catalyst Proprietary and Confidential19
- 20. © 2016 Health Catalyst Proprietary and Confidential Care Companion 20 Screenshot comes here
- 21. © 2016 Health Catalyst Proprietary and Confidential Poll Question #2 21 How effective is the process your organization uses to evaluate return on investment (ROI) for your care management program? 85 respondents a) Not at all effective – 15% b) Moderately effective – 14% c) Very effective – 3% d) We have not evaluated ROI – 24% e) Unsure or not applicable – 44%
- 22. © 2016 Health Catalyst Proprietary and Confidential Measuring Outcomes 22 These can include health outcomes for a specific condition, scores on patient-reported health measures, readmissions, and other health-related outcomes. These include care utilization costs, total cost of care, ability to manage at- risk contracts within negotiated costs, and other outcomes related to the organization’s financial health or infrastructure. These include measures of patient experience, patient engagement, and improved staff satisfaction or engagement. ROI Financial Clinical Experience
- 23. © 2016 Health Catalyst Proprietary and Confidential Care Team Insights 23
- 24. © 2016 Health Catalyst Proprietary and Confidential24
- 25. © 2016 Health Catalyst Proprietary and Confidential Care Team Insights 25
- 26. © 2016 Health Catalyst Proprietary and Confidential Components of a well-organized care management program 26 Data Integration Patient Identification Care Planning and Coordination Patient Engagement Performance Measurement and Reporting EDW Patient Stratification Patient Intake Care Coordination Care Companion Care Team Insights
- 27. © 2016 Health Catalyst Proprietary and Confidential Market Challenges Learn More - https://healthcatalyst.com A Great Reference: A Guide to CM ROI Challenges & Solutions 27