The Care Coordination Value Proposition

Posted by Cordata Health

October 24, 2016 at 10:06 AM



A recent study has found that care coordination is critical to managing healthcare costs, especially relative to complex patients.

As the study notes:

“Arguably, the greatest opportunity to save on healthcare spending in the United States is through more effective care of complex patients — defined as those with multiple comorbidities, high risk for poor outcomes, and high cost. Given that such patients typically visit multiple providers, improved care coordination is one important means of improving the effectiveness of their care.”

 At the same time, many healthcare organizations struggle to define the value proposition for care coordination tools and technology. The issues arise not from dedicated or purpose-built toolsets, but rather from the lack of formalized programs and clarity in how they should be used:

“Although health IT has the potential to improve care coordination, the types of IT tools available to clinicians and patients are currently limited. We found substantial barriers to developing technical capabilities for improving care coordination, including lack of knowledge of users’ needs; lack of standardized roles, responsibilities, and protocols; required changes in providers’ work activities to achieve coordination.”

In other words, care coordination — like other strategic enterprise capabilities — requires a mix of people, processes and technology capabilities.

Prioritizing patient engagement certainly makes a great deal of sense. In our experience, its biggest payoff comes from complex patients who, according to the study:

“… incur a majority of healthcare costs in the United States, in part, because their care is poorly coordinated … Given that such patients typically visit multiple providers, improved care coordination is one important means of improving the effectiveness of their care.”

Another — perhaps bigger — issue is that many care coordination technologies lack patient engagement features that are proven to drive tangible ROI for this investment. Why is patient engagement so important? Because it’s the foundation for actual patient behavior change, which is what healthcare organizations need if they are to improve both clinical and financial outcomes. The right patient engagement tools — like those that tailor communications to the individual — also reflect that patients are people, too, and therefore may need a nudge or tow, plus encouragement if they are to comply with complex treatment plans.

So what’s the ROI? It varies by specialty, of course, but the business case is built on fewer readmissions and missed appointments, less outmigration and faster identification of high-risk patients. The value can be measured in the millions of dollars, both in terms of cost reductions and revenue increases.

Looking at healthcare technology more broadly, organizations that rely on EMRs for care coordination are highly susceptible to the problems of poor coordination. After all, EMRs weren’t designed to handle care coordination. And interoperability remains an issue.

The bottom line: care coordination value proposition is multi-dimensional and unique across specialties and organizations. But in our experience, it’s clear and compelling. Contact us today and we’ll gladly help your organization define yours.

Topics: ROI, health IT, Navigation & Care Coordination, Patient Engagement, Chronic Care

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