Reading Time: 3 minutes
A message from Amy Ostrem, Senior Product Manager, MatrixCare
Over 900 people gathered in Phoenix, Arizona, the first week in October for the annual Change Healthcare conference. With over 160 education sessions to attend, the conference was packed with innovation and regulatory updates that stretched my thinking.
Change Healthcare is a 17-year partner of MatrixCare with a strong footprint in healthcare and expertise in payer electronic connectivity; processing 12 billion transactions and $2 trillion in claims annually. Change Healthcare supplies our robust claims clearinghouse capabilities to MatrixCare clients.Change Healthcare is a 17-year partner of MatrixCare with a strong footprint in healthcare and expertise in payer electronic connectivity Click To Tweet
Attending this event and educational sessions ensure networking opportunities and learnings around optimization that MatrixCare clients can benefit from. In this article, I will focus on two key sessions that I found valuable from the conference:
- Success and Learnings in the Transition to Value-Based Care
- Looking Ahead (the Roadmap session)
Success and Learnings in the Transition to Value-Based Care
The Value-Based Care session was a panel discussion with two chief medical officers from different practices/environments and a senior director of consulting from Change Healthcare. Overcoming challenges and strategies were key components of this session, and as you would guess, the readmissions topic took the driver’s seat. Here are key takeaways that are demonstrating positive results:
- Educating patients/residents on when to go to the emergency room vs when to see their primary care provider
- Following up with patients/residents after they go home to ask: if they have questions, are they taking their medication, did they receive the additional supplies/equipment that was ordered, are they able to use the supplies and equipment properly, are they able to make it to their follow up appointments?
- Providing physicians, care coordinators, and your care network(s) with all the data from your organization that allows you to position it in the very best light: readmissions, outcomes, quality ratings. This way, patients and their families are making an informed decision vs just relying on a referral.
- Providing physicians with their data monthly or at least quarterly. Analytics knowledge is critical, and it will help and encourage a provider to further engage with patients. One ACO group gathered analytics on emergency room visits and challenged the physicians to work together on improving their statistics, efficiencies, and providing a recommended path forward. MatrixCare MyAnalytics offers a compelling variety of readmission statistics.
- Providing data to physicians to also help them generate a risk profile for their patients based on available benchmarks.
- Using readmission data to identify strong partners that will help decrease overall cost and provide more value to increase gain sharing across the continuum.
Looking Ahead (the Roadmap session)
In this session, we learned of upcoming projects and themes that Change Healthcare will be focusing on in the next 12 months. Expect to see energy and enhancements around Denial Prevention, Revenue Recovery, and Enterprise Management. There is a data sciences team at Change Healthcare participating in these efforts, and there are three topics of focus as we approach 2019:
- Recoverable Denials vs. those not Recoverable (helping clients to assign priority on which to work first)
- Avoidable vs Unavoidable Denials (driving denial prevention)
- Root Cause Analysis of Denials (enabling clients to drill down further into categories of denials)
Claims Management Acuity Analytics was a hot topic as this additional denial reporting will be available there, along with expanded remit data available for reporting (which allows easier remit analysis in the event the remit is not tied to a specific claim). The buzz among Change Healthcare clients was that the Claims Management Acuity Analytics tool is a must-have for success in denial management. There are webinars and product information on this if you would like more information. Over 1500 claim-related data elements are supported in this tool that lays over the top of Claims Management.