In the rapidly evolving healthcare landscape, the mission to close care gaps has shifted from a nice-to-have to a must-have for primary care practices, IPAs, ACOs, CINs, and Health Systems alike.
The chase is not just about patient care anymore; it's about money on the table. Care gap closure is now a high-stakes game thanks to complex financial incentives woven into payer contracts.
HealthHelper stands at the forefront - tackling the myriad challenges primary care practices and their networks face when trying to close care gaps. With a proven track record of closing thousands of care gaps for our partners, we've cracked the code. Now, we're pulling back the curtain to share our expertise and strategies. Join us as we dive deep into the world of successful care gap closure.
Let's explore our comprehensive four-step approach to care gap closure:
1. Zeroing in on the Gaps: Uncovering Care Gaps within Your Patient Panel
Reliable software platforms, including Arcadia, DignifiHealth, Innovacer, and Lightbeam, have revolutionized care gap identification. These systems combine both EHR and claims-based data with powerful clinical metric calculation engines, demonstrating impressive accuracy when implemented correctly.
However, no system is flawless, and care gap identification accuracy rates are never 100% due to a variety of healthcare data issues. Therefore, at HealthHelper, we adopt a cautious approach, considering these identified gaps as "purported care gaps". This entails confirming the existence of a care gap before scheduling an appointment.
2. Confirming and Prioritizing: Assessing Patient Charts and Prioritizing Efforts
Having identified the "purported care gaps", we then confirm these gaps and determine the need for outreach. This is essential given that the data used to identify care gaps is not infallible and the need for outreach can be nuanced.
At HealthHelper, we have developed a patient prioritization algorithm that takes into account various factors to maximize clinical and financial value. This algorithm enables us to focus on high-value appointments, thereby optimizing your providers' schedules while scheduling recommended appointments in the community. This translates to more productive appointments and less follow-up work for your staff.
3. Outreach for Scheduling: Delivering Convenient Engagement and Scheduling
With the gaps confirmed and patients prioritized, we move on to outreach, which presents its own set of challenges. When it comes to outreach workflows for your organization, here are a few of the tough questions to consider:
Who will conduct the outreach?
Is this staff trained and equipped to schedule various types of appointments?
What communication channels will you use?
What is the sequence of outreach (e.g. a phone call, a text, an email, then another call)?
How will your staff stay on top of all these outreach attempts?!
How will your staff handle responses?
How often should you reach out to a patient?
What languages can your staff support?
Which facilities and specialists will you guide patients to use?
Can your staff schedule with these providers?
The most critical consideration here is ensuring that you're providing a positive patient experience. The goal is to make it easy and convenient for the patient to schedule an appointment. Sending SMS text messages to patients that instruct them to call the office or a centralized scheduling department - only to sit on hold during their workday - can result in poor patient experiences. Like in every part of their lives, patients want to be able to schedule conveniently and immediately.
With HealthHelper, we make it easy for your patients by directly scheduling appointments at your practice and in the community over their channel of choice. In fact, over 70% of our appointments scheduled are done via text message automation - providing great patient convenience and staff efficiency.
4. Continual Learning: Analyzing Outcomes and Improving Processes
Each "Identify - Confirm - Reach Out" cycle is an opportunity for learning and refining our processes. We maintain comprehensive records and analyze them to identify the success rate, potential drop-off points, and effectiveness of different communication channels.
At HealthHelper, we are committed to learning and improving, an approach that has returned five-fold ROI and 10-30% improvement in HEDIS quality metrics for our customers. We continually examine our workflows and outreach methodologies to close more care gaps efficiently and with enhanced patient satisfaction.
Our expertise in panel management technology and care coordination services ensures the successful and efficient closure of care gaps, optimization of provider schedules, and improvement of network efficiency.
If you're interested in delving deeper into our effective strategies for care gap closure, feel free to schedule a Zoom call with our team. We're ready to share our best practices and insights. Mastering Care Gap Closure
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