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Meeting the evolving needs and demands of referral sources

MatrixCare has invested in collecting data on referral source attitudes toward interoperability over the past four years. In 2019, a significant need among referral sources was interoperability — and that need has only continued to grow. The number of referring partners that would be willing to send more referrals to a post-acute provider who could accept electronic referrals went from 60% in 2019, to 99% in 2023. This evolution of interoperability going from a want to a need signals a more connected future in post-acute care.

“Interoperability is the ability of different information systems, devices or applications to connect, in a coordinated manner, within and across organizational boundaries to access, exchange, and cooperatively use data amongst stakeholders, with the goal of optimizing the health of individuals and populations.”

HIMMS, 2019

When physicians and health systems began to take on value-based reimbursement contracts years ago, they wanted to be able to track their patients as they journeyed into post-acute care settings. Instead, those patients would disappear into what referring providers labeled a black hole and those providers were unable to monitor how patient care would progress. As interoperability evolves, we’re seeing post-acute providers become increasingly thought of as an integral part of the care team — especially for value-based reimbursement models.

When post-acute providers are seen as a real part of the patient’s care due to being more connected to physicians and hospitals, referral source attitudes shift for how a patient’s healthcare evolves in the out-of-hospital setting.

Keeping patients and payors in mind

When it comes to a referral source’s experience, there’s a parallel between working with patients and working with payors. Patients expect modern consumer-like experiences, which also results in more engaged care and increased satisfaction. Referral sources know this, so they also expect post-acute providers to allow patients and caregivers to interact with their broader care teams in a seamless manner.

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96% of referring entities said they would likely send more referrals to PAC providers with strong patient engagement capabilities

In post-acute care, we see patients with complex care and more comorbidities — often due to complicating factors such as advanced age or multiple chronic illnesses at the same time — which increases their likelihood to rely on family caregivers to help navigate their proper care. Connecting everything in a holistic way becomes increasingly important for these caregivers and for referral sources who must stay aware of patient status to meet payor demands under value-based reimbursement contracts.

Interoperability built with the future in mind

According to our research, 100% of referring entities place importance on interoperability. This is evidenced by the fact that 68% say it is very important and 32% say it is somewhat important for their PAC partners to have a basic level of interoperability

MatrixCare was built to help ensure interoperability modalities are a core part of the software experience — not an outside system or separate workflow. Our referral management work lists within the product are aligned with the needs of both clinicians and back-office staff handling patient intake. The care experience is further connected through integrated networks such as CommonWell Health Alliance or Carequality.

Interoperability is top of mind for us because it’s top of mind for our users and their most important external stakeholders — patients, referral sources and payors.

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Nick Knowlton

Nick Knowlton is the Vice President of Strategic Initiatives for ResMed, parent company of Brightree and MatrixCare. He leads the company’s interoperability initiatives, amongst other areas. Nick brings more than 20 years of business experience across sales, marketing, product and strategy roles for technology and health information technology businesses. Prior to joining the ResMed family of brands, Nick ran strategic initiatives for Greenway Health, a market leader in the physician practice EHR space.

Nick is extremely active in the post-acute industry -- he is the chair of the board of directors of CommonWell Health Alliance and is on the board of HCTAA and PDHCA, which are affiliates of NAHC.

Nick has a Bachelor of Science degree with a major in Biochemistry from the University of Notre Dame.

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