David Steele, VP, Performance Analytics & Outcomes
Succeeding in bundled payments (whether Medicare / commercial) requires management of patient care delivery throughout the entire episode, including pre-op education and testing. Performance Solutions provides clinical, financial and operational expertise coupled with intelligent and efficient data management platforms that help providers strategically enhance patient outcomes while understanding, and anticipating, the true costs of Total Joint Replacement episodes. Their platforms communicate, track, and manage bundle patients as well approaches to reduce readmissions, infections, and unnecessary utilization of post-acute care services.
Providers understand the necessity to manage care, performance and episode costs, but they are not ready to tackle this initiative today. Feeling overwhelmed with “more administrative burdens,” having other large initiatives in the pipeline (i.e. EMR enhancements, other service lines, turnover) or other factors often result in “status quo” management may mean providers fall further behind and risk being squeezed out by competition in the upcoming years.
“Our solutions enable physicians and hospitals to provide best class care while consistently focusing on outcomes improvement and success in bundled payment program opportunities,” states David Steele, MD, MBA, VP of Performance Analytics and Outcomes.
These two technology solutions provide dedicated strategic partnership through customized care plans and hands-on management tools that focus on both physician practices and service line management:
1. Episode Performance Manager (EPM) provides hospitals and surgeons with analytics to track, trend, and benchmark the cost of care for patients in a bundled payment program. EPM processes raw claims data and provides a summary of results with KPIs to compare performance against regional and national benchmarks.
Our solutions enable physicians and
hospitals to provide best class care
while consistently focusing on outcomes
improvement and success in bundled
payment program opportunities
This solution allows users to filter the results based on various parameters (i.e. procedure type, time range, surgeon, DRG code, fracture status, inclusion/exclusion of outliers). Users can view episode cost, post-acute care utilization trends, and readmission rates by individual surgeon.
2. While EPM provides a retrospective analysis of clinical and operational performance for patients in a bundle, RecoveryCOACHTM delivers real-time care navigation and patient engagement for the entire episode of care. This enables hospitals and surgeons to monitor patients at every stage of care, ensuring preparation for surgery pre-operatively and achievement of recovery goals post-operatively.
RecoveryCOACH facilitates communication among all providers, allowing them to manage by exception while efficiently managing workload and reducing inherent stress. The Care Navigator within the practice/hospital can track and manage patient compliance and progress and focus on patients who require more care and may be at greater risk for surgical cancellations/readmissions. Real-time aggregate results are available, including patient readiness, functional outcomes improvement, and satisfaction.
These data platforms accommodate relevant metrics in different geographies, comply with regulatory requirements, international privacy and security requirements. Performance Solutions is actively involved with decision makers who are laying strategic framework for future private and public opportunities within healthcare economics, such as robotic surgery.
Health Tech Outlook provides industry experts with relevant information to promote patient-centric care. From our extensive research, we are pleased to acknowledge Performance Solutions for their work advancing value-based care through clinical expertise and relevant, effective data solutions.