Population Health Management is a Two-Way Street: Encouraging Patient Engagement
Under CMS' Readmissions Reduction Program, hospitals will be financially penalized for having high readmission rates for heart attack, heart failure and pneumonia. Making hospitals financially accountable for patients up to 30 days after they leave the hospital gives hospitals the responsibility of ensuring patients have the care they need beyond inpatient care. However, the patient also plays a role in preventing readmissions. The patient needs to comply with discharge instructions, such as making appointments with physicians, filling prescriptions and taking medication as prescribed.
Hospitals' strategies to improve patient care and reduce readmissions can go only so far — then it is up to patients to meet them halfway and follow instructions. As hospitals try to manage population health and reach out to patients with chronic conditions, it will be even more important for hospitals to engage patients in their own care to improve outcomes.
Establishing the hospital's role in the community
A hospital's first step in engaging patients in their care is demonstrating its value to the community. "It has to have that reputation for being a really vital member of the community — as a community resource for health and wellness," says Tom Lundquist, MD, CEO of AnewCare Collaborative, an accountable care organization formed by 13-hospital Mountain States Health Alliance based in Johnson City, Tenn.
Proving the hospital is part of the community and cares for the community helps gain patients' trust and makes them more willing to get involved in their healthcare decisions. One way hospitals can demonstrate their value to the community is by guiding patients through the continuum of care — from primary care and preventive health to inpatient care and post-acute care. "Patients need to know the health system cares for their total journey through the healthcare system," Dr. Lundquist says.
He suggests hospitals work toward creating an integrated, streamlined system of care by partnering with other providers. An integrated delivery system, such as an ACO that includes hospitals, physicians and other providers, makes it easier for patients to engage in their care because they do not have to travel to multiple places with different providers; instead, they can receive care from one coordinated system in a convenient way. "It should not be the patient's responsibility to coordinate their care. Our service should be that we create that transition and coordination," Dr. Lundquist says. "The patient's job is to get engaged."
Commit to transparency of cost and quality
Hospitals can also engage patients by providing greater transparency of the costs and quality of their services. If patients don't know the differences in cost and quality among healthcare providers, they cannot choose the most efficient and high-quality provider and reward providers for their performance with their business. "Without that knowledge, there is no way to change market behavior," Dr. Lundquist says. By offering easy access to quality and cost information, hospitals encourage patients to be more proactive in choosing their providers.
To help patients understand cost differences among providers, Dr. Lundquist suggests hospitals bill patients in a simpler manner. Currently, different areas of the hospital, such as the emergency department, radiology and the lab, bill separately for their services. If a patient undergoes a complicated procedure that involves many departments, he or she may receive several bills. "If healthcare is serious about creating a better value for patients, they should start to bundle those pieces together and create a fixed price — this still may allow for some variable costs that can be outlined in the bill, but it should be easy for patients to look at their bill and understand what services they received and at what price for their purchase. And as much as possible, these costs for services should be available in advance of elective and non-urgent services," he says.
Having a better understanding of the costs of healthcare can encourage patients to get involved in their healthcare decisions because they can understand the costs associated with each decision they make.
The same principle applies to quality data. Hospitals should actively share their performance on processes of care and outcomes so patients can make a well-informed decision about where they seek their care.
Practicing engagement with employees
Hospitals with their own health plans can refine strategies to engage patients by incentivizing their employees to make healthy decisions. "Hospitals can set an example as an employer by designing healthcare benefits to really encourage health, wellness, exercise [and] engagement with providers and primary care, especially for members that have chronic diseases that need to be managed," Dr. Lundquist says. Hospitals can then translate these employee engagement strategies into patient engagement strategies.
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