Data With A Soul: Using Utilization Management Data From Crisis Services As An Engine For System-Wide Quality Improvement
September 18, 2019 | 1:00 pm Eastern Free Executive Web Briefing Courtesy Of Topaz Information Solutions
Those accountable for a system of care have an interest in managing services to maximize the potential for wellness in community settings. Not only are higher levels of care costlier, but promoting care in the least-restrictive environment possible is more recovery-oriented and has been enshrined into law by the U.S. Supreme Court’s Olmstead decision. Thus, payers and providers have aligned incentives for reducing possible excessive use of acute care services such as emergency and inpatient care. Payers have developed many sophisticated data-driven methods for monitoring network performance.
However, these analyses are often based on financial claims data, which suffers from a 90-day lag, making it challenging to address problems early. Furthermore, such efforts may not fully realize the potential for providers on the ground to contribute additional context and ideas. This session will describe how a crisis provider (Connections Health Solutions) and payer (Cenpatico Integrated Care) collaborated to develop a quality improvement process based on crisis utilization data. In our model, a crisis visit is considered a potential missed opportunity for community stabilization. Daily data on crisis visits is sent to the payer for more up-to-date trending analysis. Leaders from both organizations meet regularly to review the data and develop multiple rapid-cycle improvement projects for both adult and youth services. In the first year, we achieved a 30% reduction in crisis readmissions and a 40% reduction in the number of high utilizers presenting for crisis services.
Discuss the importance of using data to evaluate network performance
Describe how rapid-cycle quality improvement can be used to decrease readmissions and service overutilization
Apply lessons learned to problems in his/her own setting
Registration for this executive web briefing has been provided at no charge courtesy of TopazIS.
Unable to attend? Still register! At the conclusion of the event, all registrants will receive a recorded copy of the executive web briefing and presentation slides.
Topaz Information Solutions LLC was founded in 2000 by two large, community-based behavioral health organizations seeking a platform to facilitate communications and clinical interoperability between organizations comprising a patient’s care team. In partnership with NextGen Healthcare®, Topaz Information Solutions LLC delivers technology solutions to behavioral health and social services organizations pursuing integrated care through the deployment of robust EHR, Practice Management, Patient Portal and Mobility Solutions. Learn more at www.topazis.com.