September 12 2018 | 0 Comments | 54 reads Average Rating: 3

Population Risk is Coming Your Way: Are You Prepared?

by SCIO Health Analytics in Population Health

Survey conducted by Health Leaders Media in collaboration with SCIO Health Analytics® in March 2018 illuminates how healthcare organizations are leveraging data and analytics to create a 360-degree view for action and some of the challenges that they are facing in managing at-risk populations.

It’s pretty much a given that as value-based care becomes more prevalent, health care organizations will be called upon to manage more risk. Being prepared to do so, however, is not such a sure thing – as only 14% of healthcare leaders surveyed said that they were “very prepared” to manage additional risk.

More than half of the survey respondents have recently taken on or will soon be adding additional risk into their mix. What does this mean? Ensuring a comprehensive risk management strategy has never been so critical.

With all of this risk on their plates, organizations must look to the right IT solutions for a comprehensive view of their risk. The big question: Will current EHR systems do the trick? The answer: Probably not. In fact, only one-quarter of leaders surveyed said they are getting a “very comprehensive view” into quality via their EHR systems.

Regardless of the type of system that organizations are using, however, the greatest hurdle standing in the way of getting a comprehensive view is most likely an inability to look outside of their own networks, fragmented data ownership and data silos, and lack of resources. Survey respondents said they are struggling to produce what’s needed as they deal with less than optimal human, capital and technology resources.

While current solutions are not offering everything needed to manage population risk, they are providing some help. More specifically, they are proving to be valuable when it comes to identifying opportunities to close open care and documentation gaps. The question is, are providers seeing all open care and documentation gaps across their patient populations or just those within the four walls of their organization? How comprehensive is their comprehensive view?

The jury is still out on whether or not currently used solutions can ultimately help to close coding gaps. A little more than half of healthcare leaders surveyed said that these systems are doing what’s needed when it comes to closing coding gaps while a little less than half of the respondents had their doubts.

While organizations realize they will have to manage at-risk populations in the future, many of them are not yet doing so. More than half of respondents indicated that they are currently managing risk for 29% or less of their populations. These numbers are likely to escalate, though. And, when they do, organizations will be looking to implement the solutions that can ultimately and comprehensively manage population risk.

Although it is expected that organizations will manage more risk in the future, trailblazers have been doing so for quite some time. Indeed, almost half of the leaders participating in the survey said they have been managing risk for three years or more. While these leading organizations are out in front of the curve, it is expected that many other organizations will follow their lead in the days to come.

The need to manage population risk is moving from the horizon to the here-and-now. As such, healthcare organizations need to analyze their current solutions to determine if they are up to the task. And, if they identify shortcomings, they need to add functionality or implement new systems that will enable them to successfully manage risk and ultimately succeed under value-based care models.

To learn more about the study, check out the Healthleaders survey brief entitled “DESIGNING IMPACTFUL PROVIDER RISK MANAGEMENT STRATEGIES”

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