The 2014 HME Handbook: Patient Outcomes Monitoring
How to Build New Services Through Patient Management
One trend across the entirety of U.S. healthcare is a nationwide focus on driving optimal patient outcomes. Case in point: Accountable care organizations (ACOs), which are groups of healthcare providers that provide end-to-end healthcare solutions that focus on optimizing patient outcomes for the lowest price.
While Medicare did not specifically create the phrase ACO, it established guidelines establishing ACOs in the 2010 Patient Protection and Affordable Care Act. The Act lets CMS set up the Medicare Shared Savings program, which lets it extend contracts to ACOs to provide services to Medicare Part A and Part B beneficiaries. In terms of number, Medicare has reported that there were 32 ACOs in December 2011; 27 ACOs in April 2012; 88 ACOs in July 2012; and 106 in January 2013. All told, there are nearly 350 ACOs across the country.
While ACOs don’t necessarily have much to do with the HME industry at the moment, they indicate where the marketplace is going: If Medicare continues to set the state for the rest of healthcare, it is likely that healthcare professionals throughout the healthcare continuum will look for partners who can help them ensure the best outcomes for the best price. And this provides HME businesses with a key opportunity: if they can create services that help better manage the care patients receive, then they will position themselves as a key player in the healthcare process.
This is where patient monitoring and management fits in. Using a variety of communications methods and remote monitoring innovations, providers serve as an information conduit to the physicians and other sleep professionals involved in the patients’ care.
Look to the Sleep Market
The real trailblazers in remote patient monitoring and management are sleep providers. From the get-go, there has been an imperative among sleep providers to provide systems that let physicians and other health professionals involved in the patient’s care remotely monitor the patient’s progress, and tweak the therapy as needed. These systems started out as data cards that would be reviewed later, after submission, but now, thanks to technology, sleep providers can offer systems that let doctors monitor patients that day.
But it goes beyond that. Physicians are busy people. By working with the physician, the provider can set thresholds within the monitoring system. This means that the doctor can go about his or her business and be alerted by the provider when there is an event. Moreover, the sleep provider can provide up-to-the-minute reports on how a sleep patient is faring through the night and whether or not his or her PAP therapy needs adjustment. Moreover, through a blend of automated and live communications methods, they can consult with patients and even ensure they are complying correctly.
Think out of the Box
Don’t think patient monitoring and management is simply a way to ensure outcomes or maximize revenue from patients. It means all new business models. By implementing monitoring and management systems, providers can leverage these strategies and technologies to position themselves as lynch pins in ensuring optimal outcomes and cost models for patients and partners, alike. That can translate into entirely new services in which the provider is delivering vital management information for other patient groups to physicians.
For instance, providers of Group 2 support surfaces and wound care services could drive all new business models by regularly checking with patients to ensure wounds are healing and that therapeutic support surfaces are doing their job. Another example would be diabetic supply providers. While patients are already collecting blood-glucose data using their monitors and sharing it with doctors, providers could take much of the busy work out of the process in ways akin to what sleep providers are doing, while also checking in more frequently. This could be particularly important for juvenile diabetes patients, where compliance can be a challenge.
In addition to automated creating new businesses, remote monitoring can also help providers maximize the business they are getting from each client. Again, the sleep market can help point the way here: When a sleep patient experiences an event, the provider might reach out to that patient to find out what happened, so that information can be reported back to the physician as quickly as possible. That dialog also represents an opportunity for the provider to drive new business.
For instance that sleep patient might ready for resupply items or other DME products related to his or her condition. That contact can be leveraged to make those transactions and fill new orders. Or, using the support surface example, a provider regularly checking in on a patient with a Group 2 support surface could use the opportunity to see if the patient or caregiver needed any additional bedding or cleaning products. Whether looking at all new business models, or just trying to make the most of existing ones, monitoring and communication yield the kind of information that can lead to new revenues.
Points to Remember:
- American healthcare is placing increasing importance on outcomes management, hence the growth of Accountable Care Organizations.
- This points to a need for providers to give referrals more information to demonstrate patient progress.
- Sleep providers have been early adopters in this regard, and have show much patients can benefit from regular monitoring.
- But this is more than just a service — remote patient monitoring can lead to a whole new business for providers willing to think out of the box.
- And, the communication engendered by monitoring can maximize existing business through upselling during patient contact, as well.
- As mentioned, the real trailblazers in patient monitoring and management are sleep providers. Physicians are depending on them to provide up-to-the minute information on patient condition, and to report serious events right away. To monitor developments in this regard, watch our Sleep Solutions Center.
This article originally appeared in the June 2014 issue of HME Business.