Care Management Analytics to Succeed in Value-Based Care

Care management analytics supports care delivery systems and population health services companies in performing a fast transfer to value-based care. Healthcare organizations that are looking for satisfying value-based payment agreements implement data analytics software to improve care management. Practice shows that rewarding doctors financially for their efforts to improve service quality and reduce expenses leads to better healthcare outcomes and the appearance of innovative care models. The experts from the Belitsoft healthcare software development company have wide experience in developing and customizing healthtech solutions. In this post, they share their ideas about the benefits of care management analytics for healthcare organizations.

If care delivery systems could readily identify and engage patients who would benefit from care management programs, they could be effectively scaled without compromising efficiency, allowing for sustainable growth.

However, a lack of analytical tools slows down the deployment of care programs and limits the efficiency of population health management. Care coordination and care management applications allow for fast discrete data gathering, determining individual caseloads and comparing them within a team, deriving a real-time picture of caseloads within teams, and making data-driven decisions about further enhancements.

Challenges that Care Management Analytics Covers

Even highly professional teams cannot be as effective as the same teams utilizing proper analytics applications. More and more provider groups are currently assuming responsibility for the overall cost of care and applying care management programs to focus on high-risk, high-cost patients. Apps assist companies in transferring to value-based healthcare. However, this process imposes several difficulties on healthcare systems. Among them are the following:

• Defining the individuals and groups who could take advantage of the care management programs and engaging them to participate in care management programs.
• Difficulties with program scalability due to challenges with the identification of potential care management participants.
• Lack of data-driven decisions and robust analytics necessary to transform to value-based care and measure the efficiency of the implemented population health initiatives and approaches.
• Difficult access to electronic medical records (EMRs) to find the data regarding risk stratification and use it effectively to assign a relevant care team and calculate the return on investment (ROI).
• Allocating proper resources to achieve better patient outcomes, cut costs, and increase value.
• Absence of a solution that combines extensive experience in value-based healthcare with proven processes to enhance and expedite population health management for physician partners.

Features of Care Management Analytics for Improved Performance

To achieve sustainable results and efficient scalability of care management programs, care delivery systems need analytical tools that can perform the following features:

• Accelerated value delivery through a concurrent implementation approach, i.e., the simultaneous execution of multiple initiatives or processes within a healthcare setting.
• Application of a customized approach to certain contexts and caseloads and qualitative and quantitative methods for patient identification.
• Automation of the related tasks in real-time allowing for proactive patient engagement.
• The possibility to analyze the actual data in the EMR, assess the reasons behind the data collection to reduce waste, increase performance, and optimize the routine.
• Optimization of the process of adding patients to the program and assigning them to care managers on the basis of algorithm-generated patient lists.
• Distributing approved patients to care management team members to ensure equal caseloads.
• Capturing the data related to patient medical documentation, interactions, and enrollment in a care management plan. 
• Assessing patient health conditions and developing care plans with goals and actions.
• Managing patient and team activities by setting appointments and alerts.
• Tracking communication with patients and team members. 
• Controlling the process of discharging patients.
• Monitoring each patient’s progress, payer statistical data, and geographical distribution of the patients enrolled in the program.

Organizational Measures to Implement Care Management Software

Implementing a new application always requires certain organizational efforts. This step is critical as it affects the outcomes and makes them sustainable.

Healthcare organizations are encouraged to develop care management programs that will build and support trusting relationships between patients and primary care providers. The team and planned interventions should meet patients’ needs and rely on technology, data, and analytics software to strive for effective care management.

Care management staff must be competent in assisting patients with multiple complex medical conditions, mental health needs, or psycho-social issues.

It would also be beneficial to carefully choose team members, explain their roles and further development, and provide them with sufficient training.

During patient intake, healthcare providers should review charts and come up with refined lists of those patients who can benefit from care management programs.

It is important for the integrated team members to track patients’ progress, care plan fulfillment, and appointments, and communicate with other team members to cooperate on patient assessment and enrolling new patients to the program.

What Benefits Can Practices Expect after Implementing Care Management Analytics?

Care management analytics is able to accelerate the deployment of care management programs. The following improvements are noticeable in the organizations that have already implemented analytics platforms:

• The software allows for the easy gathering of discrete data and user-friendly optimization of the care management teamwork.
• It is possible to formalize and monitor the applied programs and their influence on population health and financial consequences.
• Team performance improvements happen on the basis of data.
• The analytics generates advanced analysis on return on engagement.
• The system provides immediate reporting of the care management team's complete performance with real-time comparative data, rather than the weeks-long compilation experienced previously.
• The integration of additional analytics applications enables companies to calculate return on investment of their care management programs based on utilization, risk, and expenses. 
• The analytics demonstrate possibilities for further improvements in the outcomes.

How Does a Healthcare Software Development Company Assist?

Healthcare software development companies like Belitsoft focus on outsourcing the services of developing and customizing data analytics applications. Healthcare data analytics companies receive robust data operating systems and integrated analytics platforms that assist healthcare organizations in analyzing their current performance results, identifying the gaps, and improving processes to gain results from the new reimbursement model.

Healthcare software development companies build integrated data platforms that allow for gathering, storing, processing, and analyzing large volumes of data from such sources as electronic medical records, clinic management systems, laboratory systems, financial systems, etc. Those platforms offer the following possibilities:

• Automate data processing workflows (cleansing, standardization, and normalization).
• Configure scalable data warehouses.
• Set up and implement analytical tools for creating dashboards, reports, and data visualizations.
• Ensure a high level of data security and compliance with healthcare regulations such as HIPAA.
• Integrate machine learning and AI into analytics.

Healthtech companies also help build specialized analytical applications like Care Management Analytics for: 

• Capturing patient medical data (including social determinants of health), patient flow data, and payer data for continuous program evaluation and data-informed decisions.
• Analyzing the data depending on certain criteria, such as patient demographics (age, gender), clinical condition (diagnoses), disease cohort, etc.
• Visualizing multiple care management use cases and performance assessment.
• Evaluating the expected cost savings for every effective patient outreach by the reason for the outreach and outreach type.

Care management software helps to concentrate medical expertise on improving outcomes for patients and smart budget allocation. Technological tools make both aims totally achievable.

If you are looking for expertise in data analytics, data infrastructure, data platforms, HL7 interfaces, workflow engineering, and development within the cloud (AWS, Azure, Google Cloud), hybrid, or on-premises environments, a healthcare software development company like Belitsoft can also serve these needs.