Date: September 28, 2023 •Lincoln Intelligence Group
The accelerating impact of Medicare Advantage on home health and hospice requires near-term hedging against decreasing reimbursement in the core business, while simultaneously planning to meet the long-term needs of patients and health plan partners. Providers aiming to move “closer to the premium dollar” will need to develop disease management capabilities in order to move upstream in the patient’s journey. Leveraging tools such as predictive analytics will enable providers to both 1) thrive in today’s fee-for-service environment and 2) identify, manage, and care for the seriously ill population to succeed in tomorrow’s managed/value-based world.
The Opportunity for Predictive Analytics in Home Care
Though predictive analytics is not new, home-based care providers are still relatively early in the learning curve of harnessing the power of these tools.
In short, predictive analytics is a form of artificial intelligence and machine learning that makes predictions by computing a particular variable or event at a future point in time. When used appropriately, predictive tools can better inform decision-making and create more personalized, enhanced patient care (right care, in the right setting, at the right time).
These types of predictive capabilities will be critical in managing risk-based populations, demonstrating value to the payers, and simultaneously enabling providers to:
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Increase: quality, patient outcomes, patient/provider satisfaction, reimbursement, census & length of stay, and operational efficiencies
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Decrease: costs, ER visits, and hospital readmissions
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