Today, an unprecedented amount of change is happening to healthcare organizations. Changes in reimbursement, rapid network expansions, new acquisitions in physicians, and new technologies demand careful attention and strategic planning for the future. As Healthcare leaders begin this transition from the old world of care delivery into the new, they must adapt and change their organizations from within to meet the demands of the new rules and success measures. With care delivery rapidly changing to meet to the new requirements of cost and quality, complexity and volatility has increased within many provider organizations who were better equipped for the old world. Healthcare leaders are taking on new and sophisticated challenges to transform their organizations in delivering care within this ever-shifting landscape. HEI’s health systems engineers work with healthcare leaders and organizations to eliminate unnecessary costs, complexity, and waste from processes that don’t drive revenue or positive patient outcomes.
Healthcare organizations through their perioperative services intend to identify risks and establish a care plan for before, during and after procedures in conjunction with physicians to manage risk. Many organizations will see their patients around 5-10 days prior to their procedures. Often not enough time for perioperative services to medicate patients if they have diseases that need to be controlled in order get them in condition for surgery, causing surgery cancellations. Social risks are also not considered, but they can impact the recovery success and readmission rates. To insure good results in patients who are scheduled for surgery, healthcare organizations must create a streamlined perioperative process that can fully identify, document and communicate risks that go beyond 5-10 days before operations.
Behavior change is key to chronic disease management and prevention. With 8 behaviors and risks driving 80% of the cost in managing chronic diseases, a patient’s social support system is the key factor in positively influencing behavior change that can reduce total costs of care. While clinical resources are often overburdened, non-clinical resources are equally under-utilized as important components of a patient’s care community. HEI Population Health Solutions are focused on chronic care management as a patient-centered approach that engages all available resources anchored around actionable, comprehensive care plans. Additionally, HEI founded HealthSignal Partners (HSP) to provide Medicare participants with hands-on, practical support to manage chronic conditions.
In an ever-shifting landscape, healthcare organizations continue to deal with hurdles when it comes to Case Management. Factors include increasing denials, overburdened staff, high length of stay and inefficient patient output. If not dealt with, these challenges can result in financial, operational, as well as cultural and engagement issues. To address those issues healthcare organizations need to re-engineer Case Management value streams such as perioperative services, bed management, utilization review discharge logistics and post-acute care.