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The Healthcare Information and Management Systems Society (HIMSS) is one of the most visible players in the healthcare information and technology
(HIT) and management systems industry. Its annual conference brings together over 1,100 exhibiting companies and nearly 50,000 attendees from almost 100 countries.
The HIMSS Global Conference offers HIT and software companies an unprecedented opportunity to reach new clients and touch base with existing users. Attendees can discover how to capitalize on market trends and find solutions to their most pressing issues. Here are some of the top trends we're seeing leading up to HIMSS 2019.
Quality metrics are guidelines set by the Centers for Medicare and Medicaid Services (CMS) with the intention of recording and analyzing trends in patient outcome and prognosis following treatment. These measures were created with the goal of making healthcare more safe, effective, efficient, and affordable.
Value-based purchasing is a payment model through which the CMS reimburses hospitals based on performance, incentivizing providers to meet various goals. Hospitals are rewarded based on positive patient care outcomes, how closely providers follow best practices, and patient experience as reported through HCAHPS scoring.
Readmission rates refer to the percentage of patients who return to an inpatient care facility within 30, 60, or 90 days of an initial diagnosis and treatment due to complications. This metric can evaluate the quality of care provided to a patient, and indicate whether a clinician overlooked an existing condition or otherwise did not provide comprehensive care. According to our data on hospital quality, the average all-cause readmission rate in 2016 was 15.3 percent.
Hospital-acquired conditions (HACs) are some of the worst offenders in causing excess healthcare spending across the U.S., while also negatively impacting patient outcomes. Many of these conditions are easily preventable, such as surgical site infections (SSIs), pressure ulcers, and the presence of foreign objects in the body after surgery. While the national rate of HACs declined between 2014 and 2016, they remain prevalent in hospitals and other inpatient facilities.
It is vital for suppliers to understand the challenges their target market faces, and customize their messaging appropriately. If you manufacture antimicrobial wound closure gel, your ideal targets would be facilities with high rates of SSIs -- those are the facilities your product would most positively impact and therefore are the facilities most likely to purchase your product.
Since 2013, multiple studies have shown that higher rates of patient engagement lead to improved clinical outcomes. Engagement refers to a number of actions that patients take in the course of treatment as well as in relation to overall wellness. Those who take an active role in monitoring and managing their own health see lower readmission rates, faster recovery times, and lower healthcare costs. But getting patients to this point can be difficult.
HCAHPS satisfaction surveys are one tool providers are using to analyze how patients believe they are being treated by specific providers. The survey asks questions about the clarity of provider communication, how quickly their concerns and pain issues were addressed, and other aspects of the care experience. Industry leaders hope the results of these surveys will foster greater trust between clinicians and patients, improving the likelihood that patients will follow prescribed treatments.
Technology is another useful tool in measuring and improving patient engagement. The prevalence of wearable health devices, such as the Fitbit, Apple watch, and digital glucose monitors, make it easier for patients to access information about their health on a daily -- or hourly -- basis. If patients are aware of changes in their bodies, they are better able to seek care when they need it, reducing the likelihood of delaying an essential diagnosis or treatment.
Patient portals are another means by which patients can contact their primary care physician or other care providers. These online portals are connected directly to facility electronic health record (EHR) systems, and allow patients to ask questions, set up appointments, and track treatment progress from laptops, phones, and tablets. The mobility and ease of access could encourage patients to maintain regular contact with clinicians, reducing the risk of a major medical event going unnoticed and untreated.
Tracking patient care episodes from appointment scheduling to final balance payment is difficult, but it is vital to ensuring the financial health of a hospital or other care facility. Revenue cycle management (RCM) is the process that confirms the cost of care provided is equal to the payments and reimbursements received. The way revenue cycles are monitored is changing due to the industry-wide shift from fee-for-service care to value-based care. Clinicians are encouraged to only perform testing they believe is absolutely necessary, and are reimbursed based on patient outcomes rather than services delivered.
If RCM is improperly maintained, and reimbursements do not fully cover treatment costs, care facilities could easily slip into bad debt. Bad debt is when patients do not or cannot pay the total cost of treatment, and influenced by several factors. Some patients do not qualify for financial assistance, such as Medicare, or don't know how to apply. Uninsured patients may be unable to cover copays, deductibles, and other costs.
Losing track of patient payments could also limit the amount of uncompensated charity care a facility is able to provide to uninsured and vulnerable patient populations. By preventing a facility from incurring bad debt, RCM safeguards a facility's ability to pay clinicians and other staff, order necessary supplies, and provide community health & wellness programs. If enough episodes of care go unpaid, facilities could face cuts to programs and staffing, as well as raise costs to cover the unpaid invoices.
RCM software helps providers keep track of processing claims, claim denials, and data analytics to prevent unexpected financial losses for a facility. The easier-to-use and more integrated an RCM platform is, the more likely a facility is to use and remain loyal to it. Financial health is a priority for care facilities, which rely on financial stability to staff the best-available clinicians, regulate medical and surgical supply services, and deliver the best possible care to the patient population.
Interested in learning more about how our healthcare technology intelligence can help your organization meet its business goals? Come see us at Booth #2770! Reserve a time to meet with one of our team members at the links below: