2016 has been quite the year when it comes to changes in health care. From proliferating technology to an increased focus on patient engagement, there have been great strides in treatment innovation and managing how providers care for patients.
Thanks to the Presidential campaign much discussion of the Affordable Care Act (ACA), but this year also featured the final ruling on the Medicare Access and CHIP Reauthorization Act (MACRA), along with continued motion toward value-based payments for providers.
In fact, many of the biggest events in health care this past year have been related – either directly or indirectly – to care coordination and patient engagement. Research is finally starting to show the value of care coordination. And policymakers are beginning to support further implementation through legislation. With a new year upon us, now is a great time to look back on some of the most significant stories and developments in the industry from the past year.
Changes to Medicare mean more emphasis on patients and care coordination. In November, Medicare announced significant changes to its payment model for primary care, care coordination and mental health care, bringing with it an estimated $140 million in additional funding in 2017.
We’ve already begun to see the benefits of care coordination on patient populations' health outcomes, but it’s also critical to managing health care costs. More federal funding means stronger incentives for providers to coordinate patient care with other physicians and specialists.
CMS releases the final MACRA ruling. In October, the Centers for Medicare & Medicaid Services (CMS) released the final MACRA ruling. This government program will begin to move away from the traditional Medicare payment model and towards a value-based reimbursement system over the course of the next few years.
Payment models have been a prominent point of discussion within the industry, including whether bundled or capitated payments are better suited to providing higher-quality care at lower costs. Whatever the answer, though, it’s clear that care coordination pays off. Even leaders at the largest EMR providers are seeing the benefits of putting the patient at the center of treatment.
AHA urges Congress to remove care coordination barriers. This past July, the American Hospital Association (AHA) submitted a report to Congress, in collaboration with the Department of Health and Human Services, which examined specific barriers to health care delivery created by outdated laws pertaining to fraud and abuse.
While the report focuses on fostering teamwork and accountability along with bolstering anti-kickback laws, there are many factors contributing to poor care coordination, some of the largest being patients’ insurance status and EHR interoperability (or lack thereof). Proper technology implementation creates a culture of individualized, effective treatment.
Sarah Cannon and AONN+ collaborate to launch cancer moonshot initiative for improving oncology nurse navigation. Sarah Cannon and the Academy of Oncology Nurse & Patient Navigators (AONN+) announced a joint project this past October that will invest $12 million in improving oncology nurse navigation, as part of Vice President Joe Biden’s Cancer Moonshot Initiative.
Similar programs, including President Obama’s Precision Medicine Initiative, are paving the way for wider implementation of care coordination not only in oncology, but also across other specialties. With the “cancer tsunami” that’s predicted to hit as baby boomers continue to age, having patient-centered programs in place is crucial to continuing to provide quality care and foster innovative treatments.
Care coordination is the biggest challenge to population health management. A survey of health care IT leaders conducted by Philips found that 23.5% of those surveyed believed care coordination was the biggest challenge in efforts to achieve population health management.
It’s no secret that one of the biggest problems in the industry is poor information sharing. Further, one of the most prominent trends driving the adoption of care coordination is that small populations of complex care patients supply much of health care’s cost. Patients with complex care paths need the guidance that coordinated treatment allows, and being able to share information with other physicians and specialists is key to managing population health.
Caregivers of patients with cancer experience increased stress and responsibilities. A report from the National Alliance for Caregiving, in partnership with the National Cancer Institute and the Cancer Support Community, analyzed data from a 2015 study to identify ways to improve the lives of cancer caregivers and help them provide better care for their loved ones.
Many of those people providing care for cancer patients are relatives or friends, and the added stress can take a toll on all involved. However, only 54% of caregivers spoke to a provider about their recipient’s needs. The lack of education and coordination can often make care tougher and less effective than if more resources were available. And even for professionals, it’s hard to understand the spectrum of emotions unless one has gone through the experience themselves.
Care coordination improves outcomes for dual-eligible patients. CMS released a report this past June revealing that patients enrolled in both Medicare and Medicaid had better treatment outcomes than those enrolled in either one alone. This integration of services highlights the benefits of coordinated care, with enrollees in both programs being 48% less likely to require a hospital stay. The more coordination there is among insurers and providers, the better patient outcomes will be, especially for those with complex care paths.
American Cancer Society recommends care coordination for head and neck cancer survivors. The American Cancer Society issued a guideline in March highlighting the need for improved coordination during survivorship. The release focused on survivors of head and neck cancer, and suggested that coordinating care between providers and specialists can better treat health problems associated with aging.
There are many issues that come with survivorship for patients of all ages, most prominently pain and side effect management. Coordinated care ensures that survivors do not slip through the cracks and are able to continue receiving the care they need weeks, months and years down the line.A lot has happened in the industry this year. And that’s just a small selection of the work that is going into making treatment a more holistic, patient-centered experience. As 2017 comes around the bend, we at Cordata are excited about all of the potential developments in the coming months, and are motivated by all of the hard work that our colleagues in the industry put into making health care less about the diseases, and more about the people.