By Lori Lawrence and David May, Business Development Executives, Lumeon
Lumeon participated for the first time in the National Association of ACOs (NAACOs) fall 2019 conference, which took place September 25-27 in Washington, DC. We’re delighted we did. It’s been one of the event highlights of the year for the team, who had the opportunity to meet with engaged and passionate thought leaders in the ACO space.
The event made it clear that ACOs have damaging technology gaps. Lacking effective tools leaves them unable to cope well with the fragmented, operationally complex nature of modern medical care. As administrative inefficiency accounts for about one-quarter of ACOs’ total costs, making processes more efficient is the key to improving the effectiveness — cost structure — of ACOs.
Specifically, ACOs have difficulty covering the various gaps in care coordination and communication required to deliver effective post-acute and palliative care, set up patient recalls, and prevent patient readmissions and leakage. An example of a lack of coordination that costs ACOs dearly is on lab tests that patients do not complete. Labs are often unable to finalize their reports without a particular test, meaning that the lab loses money on that patient’s report and the ACO receives no reimbursement from Medicare.
Other inefficiencies are caused by insufficient communication with patients and their families, particularly in care transitions. When patients are discharged from skilled nursing facilities or rehab facilities, for example, they require post-acute care at home based on specific protocols. It is extremely important to communicate with family members both while the patient is in the facility and after they are brought home in order to ensure adherence to these treatment protocols, and therefore reduce the rate of readmissions. Many ACOs find this challenging, resorting to reliance on high numbers of care managers, impacting the top and bottom line.
Increased efficiency starts with effective care pathway management (CPM). Lumeon’s unique technology platform can help ACOs by orchestrating both clinical and operational aspects of care delivery around the needs of the patient, and across care settings, so that ACOs can achieve the goals of risk-based reimbursement.
CPM addresses costly scheduling, no-show and readmissions problems by designing communications pathways with automated touchpoints, timers and escalations to robustly engage the patient and increase the probability of compliance — whether that’s attending their appointment, returning a lab sample, or monitoring patient-reported outcomes during post-acute recovery.
Leveraging virtual interactions, remote monitoring and synchronizing care team activities across the care pathway allows for digital care coordination. As value-based reimbursement models become more entrenched, and ACOs take on increasing levels of risk, the use of technology to support care coordination becomes even more important.
It was encouraging to learn more about ACO leaders’ strategic priorities and showcase Lumeon’s CPM platform capabilities with those at the conference. Many we spoke to could see immediately how care pathway management would revolutionize their patient relationships and vastly improve their organizational efficiency.
We look forward to sharing our progress at NAACOs 2020.