Improving Outcomes in a Value-Based World Through Stratified Data and Patient Nurturing Tuesday November 3, 2015 9:15 AM - 10:30 AM
Presenter(s): Bob Dichter - Senior Director, Product Management Brian Sauers Sr. Product Manager Topic Improving Outcomes in a Value-Based World Through Stratified Data and Patient Nurturing Level 300 CME/CNE
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Drivers of Health Market 2.0: Fundamental Shifts Resulting Market Dynamics A Rise of Value Based Care 1 Delivery System Restructuring B Acceleration of Consumer Powered Health 2 3 New Economic and Clinical Models New Customer and Competitive Landscape Oliver Wyman Group 3
It s all connected Multiple terms for value-based care P4P (pay for performance) Risk sharing Incentivized payment Capitation arrangements Gain sharing Value-based purchasing Risk adjusted care Population health Value-based payment models are associated with improving outcomes and reducing the cost of care delivery Effective Population Health Management impacts clinical and financial outcomes, and quality reporting
Population Health: a collaborative care foundation Chronic disease accounts for 75% of our total healthcare spending* Identify at-risk patients starting with chronic conditions At-risk patients utilize medical services the most Highest costs associated with at-risk care Payers are transferring risk to providers * Centers for Disease Control and Prevention
Cost of chronic disease in U.S. $1.5 Trillion Chronic diseases are increasing healthcare costs at an alarming annual rate* Heart Disease and Stroke: $432 billion Diabetes: $174 billion Lung Disease: $154 billion Alzheimer s Disease: $148 billion * Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services
A diabetes care management team can consist of any or all of the following providers: Primary care provider Endocrinologist Nurse diabetes educator Dietitian Dentist Ophthalmologist Pharmacist Mental health professional Cardiologist Exercise physiologist Nephrologist Neurologist Podiatrist Leads to fragmented, uncoordinated & costly delivery of care
PHM to Improve Collaborative Care Comprehensive PHM involves: 1. Identifying patients at risk & with gaps in care 2. Managing risk thru chronic care mgmt. 3. Improving clinical outcomes & patient satisfaction 4. Engage patient for proactive care 5. Reducing cost
Goal: Improving Long-term Patient Health The goal is to improve the health of your patients and the community The onus for managing, improving, and reporting your patients health status/outcomes is shifting to providers, particularly primary care physicians Reporting outcomes will impact how much you get paid, whether or not your patients comply with treatment
All these things increased demands, requirements and pressure on you
Introducing NextGen Care
NextGen Care Everything you need in one place
Your gateway to collaborative, coordinated care Providers need a solution that enables collaborative care Onslaught of changes Regulatory mandates Ever-increasing level of quality reporting Increasing Practice/Staff Efficiencies NextGen Care - integrated across our entire ambulatory care suite Provides holistic patient data to the entire care team Makes it easier to access vital information and coordinate care Helps improve care quality and medical outcomes
What makes us different? Interoperable Facilitate multisource data flow with expertise of Mirth products Integrated NextGen Care is within the NextGen Healthcare enterprise. No third-party interfaces, bolted solutions Configurable Configurable automation options Scalable Hosted and server options that grow with you as you grow A one-stop shop to manage your patient population
NextGen Care Management Suite NextGen EHR Profiler/ Outreach Engine Population Management Hub Patient Portal* NextGen Share* Risk Milliman* * Optional Modules
All you need to collaborate in one integrated platform Six essential functions for collaborative care
One screen, few clicks, multiple functions View care gaps and risk score for a specific patient Produce a list of patients using EHR reports Take multiple actions for multiple patients (or individual patients) with very few clicks Goal = to identify the most at-risk patients, make the best clinical decisions, and take appropriate actions to enable collaborative care
One screen, few clicks, multiple functions View care gaps and risk score for a specific patient Produce a list of patients using EHR reports Take multiple actions for multiple patients (or individual patients) with very few clicks Goal = to identify the most at-risk patients, make the best clinical decisions, and take appropriate actions to enable collaborative care
Population Management Hub
Population Management Hub Chart - EPM/EHR/Dashboard Recall Create an EPM recall Message Send message to Patient Portal or Population Health Task Create an EPM or EHR Task Referral Create Referral (NextGen Share) Document Product an EHR Document Export Export Excel, PDF, HTML, XML, CVS or My List
Target Patients: Follow-up / Preventive Care Example: Hypertensive patients for blood pressure control Diabetic patients with A1C levels greater than seven Women age 55, who require pap smears and mammograms in May Men age 60, who require prostate exams in September
Predict, prioritize, prevent Do you really know who your patients are? Before a practice can deliver appropriate care to the patients who need it most, it must first identify those individuals. Today s diabetes patient may have been pre-diabetic last year. Not only is the patient sicker today, but he or she probably generates higher costs than a year ago.
Risk Stratification NextGen Healthcare has partnered with Milliman for risk analysis and predictive modeling for population health and collaborative care Group patients by chronic conditions, severity of illness, and demographics; and identify risk Take the appropriate action based on patients risk levels to address gaps in care
Risk Scores Data Flow User uploads CCLF, Member, Provider & Location files to Milliman Milliman processes the files Client pulls down file containing risk scores Risks are imported into NextGen
Risk Score Available to Care Managers
EHR Reporting Tool
Population Out Reach
No collaboration if you re not connected Track your outreach efforts, results, and outcomes to meet stringent reporting requirements. Provide that data to external stakeholders. Export and send information to payers and ACO leadership to show you are providing better, proactive care. NextGen Care incorporates the NextGen Share platform, enabling other connected providers to compose and exchange data.
Referral Management Access NextGen Share from the Pop Management Hub home screen. This is our integrated HISP that automates electronic referrals both inside and outside the NextGen network. The Hub makes it easy to create a referral and Find an external provider Attach documents Transmit referral package
Generate referrals with NextGen Share Find a Provider Compose Referral Send Referral MU2 Search and discover external providers Connect to multiple networks and federated HISPs Built into the KBM referral template Supports multiple attachments Uses Direct Supports MU2 core measure #15 Automates MU2 Calculations
NextGen Care What is it? The NextGen Care solution proactively reaches out to those patients with gaps in care based on selected protocols and evidence-based clinical quality measures Patients are alerted using automated communication methods to take action NextGen provides outreach tools that are highly configurable allowing each practice to determine the best solutions for their patient populations.
Patient Outreach Types of Alerts / Communications: Patient Portal Secure Message Email Text Messaging Interactive Voice Response (IVR) Worklog Recall Plan Communication limits can be determined per practice for each message type
Patient Engagement / Outreach Process is fully automated and integrated with NextGen Ambulatory EHR, Practice Management, Patient Portal and Dashboard (no third-party interfaces required) Pulls your data directly from the EHR/PM/HQM systems No additional FTEs, time, or resources needed Patient Portal EHR EPM Dashboard
Analytics Critical role in population health management Select, filter, and save different groupings of patients You ve identified high-risk patients, now what? - Slice and dice information based on what you want to know - With true analytics, identify problem areas and utilize proven clinical decision support tools - Monitor your out reach campaigns - Ultimately, drive down the cost of care!
Population Health Administration Reports Outreach Reports - Example Outreach Report
Outreach Reports Outreach Queue & History By Measure Outreach Queue by Measure Task Queue by PCP/Rendering IVR Outreach Communication by Patient Outreach Communication by Patient/PCP/Rendering Outreach Exception by Contact Method/Patient/PCP/Rendering Patient Not Contacted Patient Skipped (DNC) Outreach Performance by Contact Method/Patient/PCP/Rendering
Population Health Administration Reports Return on Investment Reports (ROI) - Selecting the ROI folder displays various reports.
Return on Investment Reports (ROI) Expected Revenue by Appointment Type Booked Appointment by Measure Measure Return Analysis Outreach Analysis Patient Response Time Details Monthly Comparison of Procedure Counts Procedure Charges by Measure Revenue by Practice
Recap: Integrated Care Management Workflow Embedded in NextGen Ambulatory EHR Non-disruptive workflow for providers / care managers Automated outreach (e-mail/text/ivr/portal ) Generate, save, and track patient list to review gaps in care Take actions from single screen, minimum clicks Access Patient Chart Access Patient Dashboard Add to Recall Plan Send message using Patient Portal & Population Health Create tasks Refer patient Generate documents
The future: 5.8 UD3 & KBM 8.3.11 Spring 2016
NextGen Care Phase 2 Provide the ability to add Alerts to selected patients for the Hub Ability to add a patient to a my list while charting on them Ability to import lists into a my list Ability to send patient education material to a patient Ability to print Care Opportunities Single Patient All Patients Ability to see what Cohort list created the Outreach
Alerts
Alerts
Add to My List
Patient Education
Patient Education
Patient Education
Print Care Opportunities
Additional Information
Additional Information Visit with one our application specialist located at the - Sales Booth Check out our web site: https://www.nextgen.com/products-and-services/population-health Client Success Stories White Papers ACO ebook
Knowledge Exchange Installation Guide for NextGen Population Health, Version 1.4 UD1 Overview for NextGen Population Health, Version 1.4 UD1 Administrator Guide for NextGen Population Health, Version 1.4 UD1 Operation Staff Training Guide for NextGen Population Health, Version 1.4 UD1 Profiler User Guide for NextGen Population Health, Version 1.4 UD1 Population Management Hub User Guide for NextGen Ambulatory Products, Version 5.8 UD2
Questions?
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