How Humana Improved Access and Outcomes

Posted by Brad Veach on Tuesday, August 15, 2017

Humana was looking for a way to enhance access to specialists and improve clinical outcomes across their provider network with a digital solution. Typically, coordinating referrals across a disparate provider network has many challenges: long delays between referral order and actual appointment, identifying appropriate specialists, inefficient appointment coordination and scheduling, and inability to track data in real time.

These challenges lead to poor patient experience, diminished access to care, wasted time, negative clinical outcomes, and increased medical costs.

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How health plans can use self-scheduling

Posted by Mary Tackbary, RN, MSN on Tuesday, May 9, 2017

No one can argue that self-scheduling of provider appointments is a bad idea. It is like Uber – once someone does it, they keep doing it and won’t go back to the old way. It provides a convenient and fast way to book appointments and corrects a persistent source of frustration and complaints related to access. And as a bonus it improves quality and reduces costs.

However, it isn’t easy for a health plan to determine the best role they should play with this technology. There are many options:

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Operationalizing Referral Management

Posted by Brad Veach on Tuesday, March 21, 2017

Many practices do their best to ensure specialty appointments are being scheduled by their patients, that attendance is being tracked and when possible, that follow-through care is actually being provided. But with most specialists on disparate systems, it can be nearly impossible.

This does not have to be the case.

When your network of preferred providers are connected through a centralized, cloud-based platform, EHR fragmentation and phone-based workflows no longer short circuit your business.

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Humana’s innovative approach to improve clinical outcomes

Posted by Brad Veach on Tuesday, February 14, 2017

Coordinating referrals across a disparate provider network is broken.

Long lead times, finding the right provider, efficiently coordinating care, and tracking the timeliness and completion of appointments are everyday obstacles.

These challenges create a time-consuming process, a poor patient experience and untimely access to care. As a result, many patients experience long delays or simply do not follow through on these referrals - correlating to lower clinical outcomes and increased medical costs.

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How ACOs can improve care coordination

Posted by Brad Veach on Wednesday, February 1, 2017

The hallmark of an Accountable Care Organization (ACO) is the ability to effectively move patients within a tight provider network to expand timely access to care and improve clinical outcomes. 

But if ACOs continue to rely on the traditional path-of-least resistance 3-way phone appointments, or force the patient to shoulder the burden of referral management - ACOs will struggle to reduce costs. Correcting this situation can improve quality measures while sharply enhancing the patient experience both for the consumer and for the practice coordinators.

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