Cost Management In Health Care

Improved Essays
HEALTHCARE REFORM
U.S. health care spending increased 3.6 percent in 2013 to reach $2.9 trillion, or $9,255 per person; the growth in healthcare over the past five year has ranged from 3.6 percent and 4.1 percent with 17.4% of GDP dedicated towards healthcare. Improving the quality of the United States’ health care system requires the simultaneous pursuit of three goals: improving the experience of care, improving the health of populations, and reducing per capita costs of health care. In order to achieve these goals, effective acquisition and management of health data is critical to engage patients, improve communications with providers, and improve overall quality of health care delivery. Health care delivery organizations such as Accountable
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ACOs must use data management and health IT to implement patient-centric models because this shift in reimbursement transfers the risk of cost management from the payer organization to the provider organization; with a fixed revenue structure, providers must effectively manage the healthcare cost of the overall patient population in order to maintain profitability. The shift towards value-based reimbursements means providers must focus on managing population health and must work across all members in the ACO group to find the most cost effective method to deliver patient care. Some steps providers can take to manage cost and improve health outcomes are:
• Delivery most cost effective interventions – Providers can use Clinical Decision Support to suggest cost effective options and conduct practice profiling to identify physicians whose delivery of services significantly deviates from the standard practice. Providers can also look at telemedicine and other more efficient service delivery options for patient
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An example of using patient centered data management to reduce hospital admissions can be seen in program at Lee Memorial Health System in Florida. The hospital sought to reduce readmissions, by 1%–2% per year, through remote patient monitoring. The health system used Honeywell’s LifeStream Solutions to remotely monitor and track patient outcomes upon their hospital discharges and detect changes in patient conditions early on and apply medical interventions. The program’s success can be attributed, in part, to a strategic plan and approach to continual improvement through data collection, data trends analysis, monthly readmission rate calculations, and analyzing clinical outcome data along with financial data to validate system cost savings. Staff also documented interventions that prevented patient readmission, for example, notifying a physician that a patient’s vital signs had fallen out of established parameters, and implemented immediate interventions. The

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