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How to Use Data to Become a Preferred Provider

PAC-Biz-dataWhen hospitals select preferred providers, they often rely on skilled nursing facilities or home health agencies that they’ve built relationships with and trust. Providers may be friends or long-time partners. Or, they might bring in lunch or treats for hospital staff. All too often the referral flow is based on doughnuts and not data. But in a value-based care environment, data matters.

Patients need to receive the right care at the right time by the right provider. Data can offer insight into productivity, quality and responsiveness. Hospitals can then use that data to determine which partners are more likely to boost positive health outcomes for patients and prevent readmissions.

Here’s how post-acute providers can leverage data to change the conversation:

Prove responsiveness

Once you’re on the Prepared Health network, you can start to focus on data. Time stamps appear at the top of each referral request and you can use that information to track how quickly you respond, accept new patients and start care. Share that data with your referral sources. You want to earn preferred provider status because you offer the highest quality care for patients.

On the other hand, if you’re losing referrals, do you know why? Use the same data to identify roadblocks in the process or any internal procedures that may need improvement.

Promote your strengths

Identify and track your key performance indicators. Look at data points including: number of patients managed, risk managed in dollars and high-need patients, average touchpoints per patient, and average length of stay. Use this information to prove all of the work you’re doing and set yourself apart from your competitors.

Understand why patients are declined

When referrals come into the Prepared Health network, you can choose to accept or decline.It’s important to reduce the number of declines and knowing the reasons why you’ve declined a referral can help. Consider these situations where you might decline patients:

· Patients are outside of your coverage area. If volume warrants, do you need to open another office?

· Patient’s insurance is not accepted. Do you need to expand insurance providers?

· Some criteria like incorrect address or safety of the home should have been identified earlier. Is there an internal process that needs to be reviewed?

· The patient’s family did not let the home health provider into the home. Do patients and family members need more education before they go home?

Try a proactive approach

Finally, if you can’t accept a patient, try to offer a warm introduction to someone who can. This is an easy and proactive way to show you’re a great provider to work with.

 


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Posted on May 2, 2019 10:00:00 AM by Liesl Petersen in Post-Acute, in bundled payments, in Hospital, in Business of Post-Acute

Liesl Petersen

Written by Liesl Petersen

With a background in social work and a MSW, Liesl has a passion for making sure those who are disadvantaged or at-risk receive the resources they need for optimal wellness. In her role at Prepared Health, she brings that same passion to our mission of helping a growing elderly population maintain the autonomy and dignity of aging at home. She believes in providing tools and technology to help families with sick or aging loved ones receive the support and services THEY need, and providing a smarter way for other bleeding heart clinicians and service workers to target their efforts more effectively.