Pay-for-performance incentives are impacting health plans’ bottom lines. To maximize these incentives, health plans need to improve quality scores by closing more gaps in care. Population health vendors have come a long way in identifying those gaps and then taking action to close them, but often times it all falls apart on the last step.
In a typical scenario, heavy lifting goes into analyzing data and organizing call centers to do outreach campaigns. Once on the call, an agent must engage in a manual negotiation – i.e. a three-way call – to schedule an appointment. This is a tedious, inefficient process. So much work goes into identifying the gap and reaching out to the patient, but then no appointment gets booked and it was all for nothing!
What can we do differently?
Enabling real-time scheduling into your network providers can vastly improve your outreach efforts in several ways.
- Email campaigns can include a “Schedule Now” button where patients can self-schedule right from their phone or computer
- Call center agents can look up providers and book them in real-time while they have the patient on the phone
- The scheduling system can capture attendance to help analyze program success
The ability to schedule members with care gaps in real-time unlocks greater scalability and efficiency. In fact, we have seen 5x more closed gaps in care when using our digital care coordination solution.
Start Small and Smart
To get this sort of solution off the ground you need to start small and expand from there. Create a small, smart network with 100 of the best, highest quality doctors first. Then gradually expand to additional doctors and new cities, implementing blue ribbon providers first. Building this smart network is a key part of launching this initiative.
Helping close gaps in care supports better population health initiatives designed to be efficient and effective. Better care, health outcomes and happier patients feeds directly into quality scores, positively impacting patients’ health outcomes and your business’ bottom line.
To learn more, read our case study about a Medicaid Managed Care plan that closed 5x gaps in care with less than half the resources.