Value-Based Care (VBC) is a patient-centered approach to healthcare that places the focus on quality and efficiency over the volume of care provided.
The authors of a 2019 article in Academic Medicine — Defining and Implementing Value-Based Health Care: A Strategic Framework — emphasize the goal is enhancing the value of the care provided to patients.
“By focusing on the outcomes that matter most to patients,” they write, “value aligns care with how patients experience their health. In this context, health outcomes can be described in terms of capability, comfort, and calm.”
True value is achieved when there is an improvement in a patient’s health outcomes; it does not solely focus on reducing costs.
healow solutions such as healow Insights, Real-Time Benefit Checks (RTBC), and Electronic Prior Authorization (ePA) are proving instrumental in facilitating this transformation and improving healthcare delivery.
Harnessing healow Insights for Comprehensive Care
healow Insights is a cutting-edge, cloud-based service designed to streamline data exchange between health plans and providers. By automating this bidirectional exchange, healow Insights offers clinical staff a 360-degree view of patients’ data. This comprehensive perspective allows providers to make informed decisions and deliver improved patient care.
Key features include:
- Data Retrieval: Efficient extraction of essential data from patients’ charts ensures immediate access to relevant medical history.
- Point-of-Care Alerts: The system generates alerts that identify gaps in patient care, enabling providers to address issues promptly.
- Pharmacy Integration Services: By integrating pharmacy services, healow Insights supports medication compliance and reduces prescription costs, critical to delivering value-based care.
Maximizing the Benefits of Real-Time Benefit Checks (RTBC)
Real-Time Benefit Checks (RTBC) complement healow Insights by providing immediate insights into healthcare benefits at the point of care. RTBC offers real-time access to patient eligibility and out-of-pocket costs, enhancing transparency and efficiency.
Key advantages include:
- Transparency: Patients gain a clear understanding of prescription costs, enabling informed decision-making and financial planning.
- Efficiency: Streamlined communication between healthcare providers, patients, and payers reduces administrative burdens and accelerates the prescription process.
- Improved Outcomes: When patients understand their financial responsibilities, adherence to prescribed treatments improves, boosting health outcomes.
Enhancing Prescribing Practices with Electronic Prior Authorization (ePA)
Electronic Prior Authorization (ePA) has expedited the approval of medications, reducing delays associated with manual authorizations. This feature ensures that patients receive timely treatments and helps maintain operational efficiencies.
Key Benefits of ePA Include:
- Reduction in Administrative Burdens: By automating the prior authorization process, ePA minimizes manual paperwork and streamlines communication between providers and pharmacies. This allows physicians to focus more on patient care rather than administrative tasks.
- Improved Patient Satisfaction: With quicker prescription processing, patients leave the office confident that their medication needs are being addressed promptly, fostering greater trust in their healthcare providers.
- Accurate Medical Records: Medications are held in a pending state until authorization is obtained, preventing errors in medical records and ensuring consistency in care documentation.
At Pioneer Physicians Network, the implementation of ePA has resulted in over 12,000 electronic prior authorizations since November 2023, illustrating the significant impact this technology can have on operational efficiencies and patient care.
Creating a Synergy for Value-Based Care
When combined, Healow Insights, RTBC, and ePA form a powerful synergy that propels healthcare practices toward their value-based care goals. These tools work together to ensure that providers and patients are better informed and more engaged in the care process.
- Enhancing Clinical Decision-Making: Comprehensive data access allows providers to make clinical decisions that align with best practices while considering financial implications for patients.
- Optimizing Care Delivery: Identifying and closing care gaps ensures that patients receive timely interventions, preventing the escalation of conditions.
- Boosting Medication Adherence: By making prescription costs transparent and offering generic alternatives, providers can recommend more cost-effective treatment plans, increasing adherence rates.
- Strengthening Provider-Payer Collaboration: Automated data exchange fosters stronger partnerships between providers and health plans, aligning both parties toward achieving better health outcomes and cost efficiencies.
A Win-Win Situation
As healthcare practices continue to embrace these innovative technologies, they move closer to realizing the full potential of value-based care. By leveraging healow Insights, Real-Time Benefit Checks, and Electronic Prior Authorization, practices can significantly improve their operational efficiencies and patient outcomes.
These tools not only reduce administrative burdens but also empower healthcare providers to deliver care that is of high quality and is cost effective. Patients benefit from increased transparency regarding their healthcare costs and a more seamless care experience, which can lead to improved satisfaction and adherence to treatment plans.
To learn more about healow offerings visit https://plus.healow.com/