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How Value-Based Care Streamlines Workflow and Drives Revenue

The health care industry is stretched thin on resources, workforce, and bandwidth as it struggles to meet growing medical needs. Congested workflow exacerbates the problem and affects hospitals, emergency departments, and clinics across the country. In recent years, the COVID-19 pandemic has worsened the issue.

Value-based care has emerged as a strategically significant solution. Leveraging advanced technology that combines a singular data lake, analytics, and artificial intelligence (AI), value-based care platforms can streamline provider workflow, provide faster access to information, ease physician workloads, and ultimately help drive revenue.

There are numerous areas where today’s technology can impact workflows and ease the compression on the health care workforce, maximize resources, and ease the financial strain.

• Easing Data Overload: A growing problem in our health care systems is massive data overload; hospitals and providers face an increasing need to absorb extensive reports promptly with accurate results. Advanced value-based care platforms take only seconds to process vast amounts of data and critical information. This improves efficiency and gives providers far more accessible information.

• Population Analytics: Health care organizations can use value-based care analytics to evaluate disparate demographics, identify gaps in care delivery, and maximize physicians’ access. It starts with identifying emerging or high-risk patients, whether they are grouped by specific clinical conditions or comorbidities or driven by predictive risk models. Patient outreach, either during their visit or proactively before an appointment, occurs with the goal of keeping patients healthy, reducing unnecessary hospitalizations, improving readmission rates, and shortening the length of stay.

• Customer Relationship Management (CRM) System: Health systems turn to CRM systems to manage the care pathways of the patient population by building a task list for specific conditions. Then care teams are held accountable for checking off necessary boxes on the list of treatment steps. Effective CRM system management leads to coordination of care teams scheduling patient visits and staying on top of their needs.

• AI & Machine Learning (ML): AI and ML can help providers expedite responses to interventions, removing unnecessary, often manually related workloads that congest health care systems and impede workflow. Physicians can spend less time sitting in front of a screen receiving segmented and parsed patient information and, as a result, commit more attention to patient needs and ultimate care. AI and ML—implemented through advanced value-based care platforms—maximizes limited resources in an already stretched-thin system.

• Value-Based Care Payment Technology: The size of payments that practices receive affects the number of staff they can maintain and support. A lack of resources and accounts receivable directly contributes to physician shortages. Value-based care allows practices to use bundled payment programs, including automatically converting fee-for-service claims into single bundled claims. Providers can use payment tools for contract configuration and eligibility management through adjudication and payment. If health care organizations shorten the number of accounts receivable days, the health care institution can improve cash flow and increase staff.

In the future, advanced platforms driving value-based care can provide several tools: streamlined medical data, analytics processing, and enhanced patient interventions are just a few examples. In addition, standardizing and automating workflows centered on evidence-based medical guidelines and best practices can further extend the reach of physicians, maximize resources, and drive revenue.