From the November 2016 issue of HealthCare Business News magazine
• They give payers and providers a way of checking in to make sure that patients understand the directions they were given at the hospital and, critically, whether or not they are following those directions, and why. Each of these aspects of continuous patient engagement figures into a meaningful feedback loop. Data about patients’ experiences with specific illnesses and treatment plans can be mined to discover unexpected complications, identify typical stumbling blocks in the aftercare period and capitalize on strategies the sufferers themselves practice. Those insights can be added to instructional videos and streamed to patients joining that community. And either payer or provider care coordinators can then assess the effectiveness of those videos.
Payer/provider collaboration platforms
The new watchwords of the payer/provider relationship are shared control and transparency — both of which require access to shared information in real time. Much has been written about payer/provider collaboration, but that’s because it is one of the most critical relationships in the new ecosystem due to these entities’ size, influence and regulatory burden. If payers and providers do not work together to deliver value jointly, they will appear too out of date and too out of touch to the new health care consumer — making both even more vulnerable to quicker, nimbler competition.
Together, payers and providers are tasked with taking on new populations and making them healthier. Targeting the largest existing costs in the system, such as chronic care, payers and providers must use newly available data to incentivize consumers to comply with care management pathways. They can leverage shared technology platforms for regular screenings, remote patient monitoring, adherence to prescription drug regimens and even lifestyle changes. When patients with chronic issues follow treatment plans correctly, providers can glean important clinical data that can improve treatment, and then feed that information back in to the payers’ selection of consumer incentives. Data integration and interoperable systems are, of course, necessary steps to effect this type of feedback.
About the author: Bipin Thomas is a renowned global thought-leader on consumer-centric health care transformation. Thomas is a board member of HealthCare Business News magazine and chairman of ICURO, a digital business outcomes management organization.Back to HCB News
