Health systems and payers have both invested heavily in creating comprehensive networks that deliver high-quality healthcare.
But too often, these systems expect patients to self-navigate their care journey. That leads to access issues and attrition as some patients go out of the network for subsequent care.
At a November session sponsored by Care Continuity at the Becker's 10th Annual CEO + CFO Roundtable, Kyle Callahan, chief strategy officer, and CEO Steven Mason, both of Care Continuity, shared insights into how their unique software platform is helping health systems assist patients on their journey while delivering a return on investing in a patient navigation solution.
Three key takeaways were:
1. Patient navigation, or lack of it, is a major source of attrition and loss for healthcare systems. Patient self-navigation creates access issues as some patients, particularly those facing social determinants of health factors, wind up falling through the cracks. Mr. Mason relayed the story of a conversation with a hospital CEO who said her hospital was losing $30 million in revenue to the competition.
"Without a patient navigation program, patients rely on self-navigation and ad-hoc communications with the providers to navigate care along this journey," Mr. Mason said. "And we're not just talking about going from the emergency department to a specialist. We're talking about patients' navigation for life and the importance of keeping them within your network."
2. The Care Continuity platform offers a navigational overlay and strategy to stop patient outmigration. Care Continuity's approach integrates providers across a network, lifting the care logistics burden. "Our navigation solutions support the entire patient journey," Mr. Callahan said. Its initial "opportunity assessment" shines light on where health systems can get the most from their investment into care navigation, based on the company's data troves and rich experience. "With all of the patients we're navigating on a monthly basis, we know which ones you can effectively move the needle on," Mr. Callahan said. " I'd love to navigate everybody at the highest level. But it's not cost effective; it takes too many resources."
3. Care Continuity has delivered returns on investment to health systems of at least 378 percent by increasing appropriate utilization after discharge. With one national health system, Care Continuity discovered that though many patients were coming in through various access points, they were going elsewhere for follow-up care because they simply couldn't get a visit with the originating provider in a timely fashion. Those insights allow the company to help health systems focus their navigation efforts on those specific patients where it will matter most.
With its varied modules to assist health systems in gathering the information and data to reshape their patient navigation systems, Care Continuity is uniquely positioned to help hospitals and health systems retain patients and provide a better patient experience, leading to better outcomes for patients and increased revenues for health systems.