Predictive Technologies in Practice
Our research into how home care providers are using predictive analytics revealed two main camps:
1. Optimizing for Today:
Today’s largely fee-for-service environment has the majority of providers leveraging predictive tools to optimize their day-to-day operations, meet current CMS quality measures, and capture reimbursement opportunities otherwise left on the table (e.g. service intensity add-on (SIA) payments). The focus is end-of-life patients (i.e. final 6 months) and measures such as likelihood of mortality in the final seven days, likelihood of hospitalization, resource planning (scheduling & staffing), and hospice visits last days of life (HVLDLs).
2. Planning for Tomorrow:
For others, predictive tools are the solution to help prepare them to go “upstream” and identify and manage the seriously ill population – that is, those patients that are approaching end-of-life.
These providers are focused on measures such as likelihood of serious illness and/or mortality in the last 18-24 months, tracking the progression of serious illness, patient severity/risk stratification, and identifying readiness for earlier interventions and transitions of care.
Both And...
At Lincoln, our perspective is that this is a “both and” conversation. Providers can’t afford to just stand still today. There need to start preparing for a value-based world is imminent and it will be critical for home-based care providers to hit the ground running when it comes. We believe predictive analytics will play an important role in this shift.
Next Steps
Those interested in learning more can schedule a briefing with senior analyst Betsy Hansen. In this 25-minute briefing, we will review the market trends, discuss and compare the evolving landscape of predictive analytics solutions gaining traction in the market today, as well as highlight the key value-drivers predictive tools can bring to your organization.