The Essential Elements of Value-based-care Success

For a medical practice to operate successfully, all its constituent parts need to fit together as seamlessly as the atoms in a molecule—because that’s what it takes to succeed in today’s changing healthcare environment.success-blog-image

In a water molecule, for example, the oxygen atom is balanced and supported by the push and pull of two hydrogen atoms. This simple structure nourishes all life on the planet. But remove one of the atoms and the molecule ceases to exist, breaking down into its component elements of hydrogen and oxygen.

In much the same way, a medical practice is held together by the push and pull of different elemental forces. The doctor is supported by—but also has to balance the demands of—the clinical and financial sides of the practice. When this is done successfully, the result is a caregiving structure that nourishes the health of the patient. If the balance is lost, however, the practice begins to break apart, disrupting the equilibrium between the business of medicine and patient care.

Keeping this already precarious balance has become even more challenging with the shift to value-based medicine, which has altered the healthcare paradigm from doctor says/patient does to doctor/patient collaboration—adding another element to the healthcare molecule—the patient. Now, in addition to keeping up with the latest clinical developments and keeping the practice fiscally afloat, doctors have to find ways to bring the patient into the loop.

This year’s User Summit gave healthcare providers a forum for discussing what it takes to succeed in the evolving, value-based healthcare environment, and it gave us a chance to showcase the innovations we have developed to help you keep the right balance between the elements.

So how do we involve patients more deeply in the healthcare process? How do we make sure that they are informed and engaged with their care team, that they understand and comply with their care plan, and that they are financially supported in maintaining care?

For us at SRS Health, the challenge is to develop solutions that reduce the barriers between the patient and the practice. This means providing practices with tools that:

  • offer both speed and flexibility,
  • improve both the clinical and patient experience,
  • remove physician and clinical team distractions while still providing true mobility,
  • streamline the efficient collection of relevant data and corresponding intelligence at the point of care, and
  • address the healthcare consumer’s role in driving patient satisfaction and practice financial health.

In other words, finding practical innovations that support all of the elements of healthcare in achieving success.

How Your Practice Should Compete in the Digital World

As technology has changed the way people receive information, it has also changed the way patients determine a care path for an injury or condition. Most significantly though, it has changed the way patients choose a specialist to treat their condition.  Practices must adapt their patient acquisition strategies to reflect this more informed and more digitally savvy audience if they want to remain profitable in the coming years.

This is especially true for practices that wish to remain independent as hospitals and health systems continue to acquire referring practices, such as Primary Care and Family Medicine.  However, too often practices do not understand the need to implement a cohesive digital strategy until they begin to see a decline in patient volume or an increase in competition.  It is important to understand the impact the digital shift has had on patients and how to use it to remain profitable.  Below are some of the basic strategies practices should be using:

A Mobile Responsive and Unique Website 

Statistically, almost 70% of medical journeys begin online with patients searching for conditions and a provider to treat that condition.  What’s more, 60% of all internet traffic now comes from a mobile device (phone, tablet, etc.).  What this means is that the majority of potential patients are researching a condition or searching for a provider on a smartphone or tablet. This is where your practice’s website becomes one of the most important tools in patient acquisition.

By now most practices have a website – but that may not be enough.  In 2014, Google began to penalize websites that did not meet the standards of a “mobile responsive” website.  What this means is that the website had to be updated to use a theme or platform that automatically detected whether the potential patient was using a phone, tablet or desktop computer and automatically reformatted the layout and navigation of the website to ensure a better user experience.  If your website does not meet these criteria, Google began to push your website further down in the results if a search came from a phone or tablet.  If patients have to spend time pinching and scrolling to be able to read the content on your site, they are far more likely to leave your website and go to a competitors’ website to find the information they are looking for.

In addition to the mobile responsiveness of your site, Google bases your placement in search results based on the content within your site.  Too often practices make the mistake of simply listing the conditions they treat or procedures that they perform.  Not only does this lack of content hurt your placement is Google search results, but it also hurts your new patient acquisition.

In a world where a wealth of information on any medical condition is accessible instantaneously, the modern patient needs more than just a bullet point on your website to ensure that you are the right doctor for them.  To increase patient acquisition, your website should have individual pages for each treatment you provide, condition you treat and procedures you perform.

A Google Pay Per Click (Adwords) Strategy

A Google Adwords Strategy gives your practice the ability to target your message to patients in your area looking for your services at that very moment.  Google Adwords allows your practice to “bid” on relevant search terms in your area and shows your results at the top of the page. Google Adwords is statistically the highest ROI digital marketing effort a practice can utilize.

The most important aspect of Google Adwords to remember is that these ads allow you to outrank your competitors for only the most relevant searches and keywords related to the services of your practice for those searching in your area.  Also, these ads are shown above the organic search results, so even if a competitor’s website outranks yours, your ad can be shown above their website.  

But, running a Google Adwords strategy on your own may be more complex than it seems and can result in wasting a large amount of dollars if not implemented and monitored correctly.  Knowing what kinds of phrases indicate a patient is simply doing research versus those terms that a patient is specifically looking for a physician can be the difference of hundreds or thousands of dollars in a month.

Social Media Marketing

According to a 2017 Pew Research Study, 67% of all Americans get at least half their news from Social Media sites.  This represents a significant shift from print and TV being the primary news sources, but does not seem all too surprising considering that the average American spends almost two hours per day on social media sites.

The likely reason for these shifts is that social media sites like Facebook serve as aggregate news sites where users can get information from all their trusted news sources, from local newspapers to national TV networks, in one single place.  Platforms like Facebook recognized very early on how to monetize the time users spent on the site or app by allowing for highly targeted advertisement being shown to their over 1 billion users.

In most cases, medical practices conceptualize social media as a place where people post pictures of their children, pets and food.  While that may be what you see externally, internally Facebook and Instagram have an incredible amount of data about their users that can be used to target specific ads to potential patients in your area.  These platforms track data points that include your age, gender, location, purchases you make, websites you have visited, interests you have and thousands of other data points.  All of this data can be used to create a behavior profile of a patient that may be in need of your services and target them with ads both on social media and on other websites they visit.

Facebook and Instagram ads are imperative for brand awareness and have become the modern newspaper or magazine ads and are far more cost effective.

What digital healthcare marketing strategies are your practice implementing to help build brand awareness with your patients?

 

daniel-goldberg

About the Author 

Daniel Goldberg is the CEO of Gold Medical Marketing and has been a thought leader for almost a decade in the field of Healthcare Marketing. Daniel has also lectured at some of the most esteemed medical conferences in the country and has contributed to many healthcare industry publications on the topics of Medical Marketing and Direct to Patient Marketing.  Daniel and his team at Gold Medical Marketing have helped practices around the country implement unique marketing strategies based on their specialty and unique patient demographics.

3 Proven Ways to Improve Practice Profitability and Clinical Performance Using Outcomes

outcomes-blog“Why should we collect data?”

“What’s the ROI of PROs?”

“How do providers and practices use outcomes data most effectively?”

These are great questions, and we get them all the time. Prospects, clients, and partners constantly look for the most valuable and effective ways to utilize outcomes data. Our answers and advice typically vary, but we inevitably reply with a question of our own: “What are your goals?” Clinic goals, quality goals, business goals, marketing goals and others factor into play when utilizing quality data.

This article focuses on the three that, in our opinion, provide the most significant ROI potential for a PRO collection program:

  • Negotiating with payers
  • Internal physician quality reviews
  • Marketing

At OBERD, we know our role: we’re the data collection experts. And for good reason: Our clients likely don’t think about data collection nearly as much as they’re thinking about how to improve their practice, how to differentiate their providers, and how to grow margin by negotiating more favorable reimbursements from payers. Outcomes data plays a role in all three. Let’s dig in.

Below, we identify three core initiatives common at most orthopaedic institutions and discuss how quality data plays a key role each.

Payer Negotiation

When preparing for payer negotiations, administrators, QA staff and physicians can gather and utilize outcomes and satisfaction data that highlight the practice’s attention to quality and demonstrate its continuous improvement in outcomes scores.

Armed with quality data relating to patients and procedures, administrators can drill down and have data-driven negotiations with payers to gain more favorable reimbursement rates in contracts.

And it’s worth it to payers. If they know a provider has high (and predictable) quality metrics, they know the provider will, more than likely, get it right the first time. They can hedge against re-admissions and complications because they have the data that demonstrates low risk.

This is especially useful in larger metropolitan areas where competition for the patient population is fierce. Providers and institutions who can demonstrate quality and value, backed by data, are a safer bet for payers.

Physician Reviews

Administrators and quality managers may struggle with physician quality reviews if they’re not armed with data-driven quality and satisfaction metrics. PRO data, especially when blended with Satisfaction data, can give an administrator a quantified view of the quality a physician provides.

Practical use cases include identifying why a surgeon’s quality scores are high for a specific surgery (or even a specific patient cohort), and utilizing that data to refine methods for other under-performing providers.

Imagine the following conversation between an administrator and surgeon: “Dr. Smith, can no longer perform a total knee for patients with a BMI over 20 because outcomes scores are too low and it makes the practice vulnerable to margin if it affects our payer contracts. Dr. Smith needs to adjust your process, perhaps by adopting Dr. Jones’s approach because Dr. Jones’s scores are above average on benchmarking reports. Or we can change workflow triage that patient cohort (<20 BMI) out of Dr. Smith’s patient schedule.”

Data-driven Marketing

It seems like every time we hear about an orthopaedic surgeon, you also hear, “he’s the best” or “she’s the best.”

Surely not every surgeon is the best, even among their local market or patient population. But practices and providers have benefited from anecdotal reputations like, “he’s the best” for years. In the future, a claim of being, “the best” needs to be backed up.

Just like so many other consumer purchasing decisions, prospective patients are first turning to the internet for reviews and fact-finding about a surgeon prior to going for a consult. Practices and providers who collect data can also demonstrate quality by leveraging data in data-driven marketing messaging.

Savvy practices have already begun advertising their data collection initiatives. Advertising shows how providers collect quality data using patient questionnaires in order to tailor care to a unique patient, or make recommendations based on “patients like you.”

That line of advertising instills a sense of ownership in the patient. They intuitively understand that the questionnaires they complete play a role in the care they receive, giving them an onus of control in the process. Therefore, data collection is an effective, credible way to market value-based care.

As seen in OBERD’s Insights Blog.

2.02% Reward for Perfect 2017 MIPS Score

final-score-100The results are in! We now know how providers will be rewarded for their 2017 MIPS efforts. You may be disappointed to see that with a perfect score of 100, the 2019 payment adjustment will max out at just slightly above 2%. And, unless a provider exceeded the exceptional performance threshold, thereby qualifying for a share of the $500 million bonus pool, the reward for successful MIPS performance is no more than an approximately 0.3% positive payment adjustment.

A survey of a few SRS Health customers revealed the following correlations between scores and payment adjustments:

2019-positive-payment-adjustments-v3

To summarize, MIPS Medicare payment adjustments fall into the following categories:

chart3

So what happened to the 4% positive payment adjustment “carrot” that the MACRA legislation appeared to offer (even before the bonus)? It vanished when CMS eased the requirements and reduced the threshold for penalty avoidance. Under the mandate of budget neutrality, with fewer providers receiving negative payment adjustments, there will be less money to share among the many providers who merit positive payment adjustments.

This was not unexpected, and a similar result should be anticipated for the next few years. The 2020 payment year (2018 performance year), offers a carrot of 5%, which will be similarly elusive. And the challenge of how to sufficiently motivate and reward providers will continue over the next few years, now that Congress has extended the transition period and relaxed the previously aggressive timetable for increasing the performance threshold.

 


 

Note:  To find out your individual or group’s 2017 final score and precise payment adjustment, log in to the QPP portal and follow the “QPP Performance” prompt. Your final score will likely be what you expected based on your attestation and/or other submission(s). If there is a difference, it could be due to new information reflected in the Quality component of your score, for example:

  • If, based on sufficient volume, you were subject to the All Cause Hospital Readmission measure, that data would be included in both the numerator and denominator of your Quality score.
  • If one of your CQMs was CAHPS for MIPS, that score will now be reflected.
  • If you reported a CQM for which no historical benchmark had been available at the time of submission, a benchmark may have been created subsequently, based on 2017 performance data.

If you believe that there is an error in CMS’ calculation of your final score—and therefore your payment adjustment—you can request a “Targeted Review” by September 30, 2018.

Are You Preparing for Appropriate Use Criteria Compliance?

auc-blogAppropriate Use Criteria (AUC) is a lesser-known government law that will affect everyone who orders advanced imaging procedures—a staple of orthopaedic practices. AUC is part of the Medicare Physician Fee Schedule regulations.

The law will impact the ordering, performing, and payment for advanced imaging procedures beginning January 1, 2020. The initial year (2020) will be an educational and testing year that will not affect payment.

Included in the advanced imaging procedure category are MRI, CT, PET, and nuclear studies. While certain specialties may not order many PET or nuclear studies, MRI and CT are staples in the diagnostic pathway and help determine care.

How does the law work?

The government is mandating that before any advanced imaging procedure is ordered, the ordering provider must consult an approved Clinical Decision Support Mechanism (CDSM). The CDSM will consider multiple factors on the patient and provide a recommendation as to whether or not the ordered procedure is appropriate or whether an alternative would be better.

At this point, providers have the choice to continue with the original order or to follow the CDSM recommendations. Information provided in the CDSM recommendation must be provided to the furnishing provider (imaging facility). The imaging facility must then include this information on the claim to the payer, and data on the choices made by the ordering provider will be stored in the CDSM for future auditing purposes.

Those who do their own in-house imaging will be impacted on the ordering and furnishing side. Your EHR, Radiology Information System (RIS), and claims management system will all need to be updated with new software to manage this.

We encourage you to speak with your EHR vendor to make the process of remaining compliant and meeting the requirements as seamless and minimally invasive as possible.

Customers or Clients… What’s the Difference?

I have read a lot of books on customer service, including, J. W. Marriott’s The Spirit to Serve and Without Reservations, as well as Hug Your Customers by Jack Mitchell, upscale clothier to the rich and famous. Both describe the service culture, personal attributes, and dedication required to build a trusted brand and to create an exemplary customer experience that keeps customers coming back.

A lot can be learned from these entrepreneurs and the organizations they’ve built. In fact, we at SRS Health have a lot in common with them in striving to create an experience that exceeds expectations. But there is one important difference. While these trusted brands sell a product or service, we are charged with offering our clients ongoing professional guidance and support.

In short, customer service involves a one-time transaction (which may be repeated if there is a good experience) while client service involves an ongoing relationship (which may not go on very long if there is not a good experience).

With the healthcare landscape changing at a rapid pace, a good client experience requires an atmosphere of mutual trust so that medical professionals can rely on their healthcare IT partners to advise them. Just as financial counselors are charged with ensuring their clients are informed and prepared to make sound investments decisions, HCIT partners are charged with ensuring that their clients have the insight to make sound decision regarding their healthcare IT investments.

But that is not all—we are also charged with providing expertise in regard to compliance, operational efficiency, patient engagement, and more. As trusted advisors, we need to know where the industry is headed, and to provide the solutions that prepare our clients to succeed in that future.

At SRS, we like to say that our expertise is helping specialists practice their expertise—we provide solutions that take care of the business side of medicine so that medical professionals can take care of their patients. In practice, this means integrating intelligence within physicians’ workflows—where it can be seen and used to help them make informed patient care decisions efficiently and effectively.

And it doesn’t end there—we also provide the business intelligence within the administrative workflow, so that business leaders can utilize the data to improve operational efficiencies, lower cost, build their practice reputation, and improve their bottom line.

A continued passion for, and commitment to, ensuring that our clients are prepared to achieve their patient care and practice profitability goals—that is how we grow our relationship and earn their trust each and every day.

Does your healthcare IT partner make you feel like a customer or a client?

Hackathon IV: Notes 2.0 and Beyond… A New Evolution Has Begun

Hackathon 1Last month, SRS Health participated in an energizing, collaborative and fun-filled Hackathon IV, a company-wide event designed to stimulate the innovative mind-set and competitive spirit of the organization to explore creative solutions for client needs.

The theme for the 4th Annual Hackathon Event was, Notes 2.0 and Beyond. Technological advancements in the healthcare space has enabled the use of various mobile devices and technologies at the point-of-care. The team was challenged to come up with ideas that revolutionize the process of capturing and documenting patient encounters, while maintaining/improving accuracy, high productivity, and efficiency for the end user.

Scores of ideas were submitted from across the organization and narrowed down to six ideas that our hackathon teams focused on. At the end of the event, the organization held a traditional “science fair” to showcase the incredibly innovative solutions developed over the one-week event.

We are excited that a number of these concepts have the potential to make it into future versions of our products. We look forward to sharing them with our clients in the 2018 User Summit’s Innovation Expo in October in Las Vegas.

At SRS Health, we strive to bring innovative healthcare IT solutions to the marketplace and our hackathon events allow the team to innovate without restraints.

Hackathon 2