As telehealth adoption accelerates due to COVID-19, medical providers are turning to healthcare data analytics to help identify and safely provide effective patient solutions for people at high-risk. In the recent nThrive “Keeping Up With COVID-19” webinar: Leverage Analytics during COVID and Beyond to Improve Physician Practice Profitability,” Kyle Kobe, vice president of Consulting and Analytics Services at nThrive, discussed how this is reshaping care delivery, leveraging healthcare data analytics to reinvent workflows and maximize operational performance during these uncertain times.
“The purpose of healthcare is to provide the best care to the most people,” explained Kobe. “As we assess the financial health of our practices with analytics, we’re also looking at how to improve practice performance in a new way during the COVID-19 crisis and recovery.
“With COVID-19, we’ve essentially had a crash course in how to provide remote care to patients,” he added. “As the curve flattens, the country re-opens and elective procedures and surgeries resume, expect a ‘new normal,’ with providers likely caring for patients more routinely through a combination of telehealth and live visits.”
Weighing the losses
While many physician practices already were struggling with profitability pre-COVID-19, revenue losses since the onset of the pandemic have been staggering, with estimates at 50 percent or greater. For hospital-based practices employing 100+ clinicians, this translates into millions of lost dollars impacting the revenue cycle across the continuum of care. While some of the shortfall will likely be offset by CARES Act relief funding, it is only expected to cover a fraction of total lost revenue.
“This new environment is creating a lot of financial pressures and putting every practice into transition,” Kobe said. “As we come out of COVID-19, we’re going to have to be different. We’re going to have to be better.”
No longer business as usual
How can healthcare organizations manage the big red number at the bottom of their physician income statement to offset financial loss? All roads lead back to the healthcare data, which invariably requires capturing information across multiple data systems to get a clear picture of what is going on. Along with consolidating data, other barriers include lack of definition around performance metrics, which are morphing as the industry shifts more toward a population health model, which is based on value versus volume.
How healthcare data analytics can help
Kobe broke down three key categories where healthcare data analytics can address immediate needs. “First, it is important to measure performance. Organizations will need benchmarks to know how they are doing compared to the rest of the market. Second, it is important to communicate so people understand what is going on. Third, organizations must act on the data to improve performance and meet today’s unique challenges.
“COVID-19 has caused us to stand up a lot of new analyses very, very quickly, so our clients can understand what’s going on. This has included volume and cash projections, bad debt ratios, accruals, reserves, all helping organizations to understand and make very acute decisions relative to staffing and cost-cutting measures.”
All the while, he noted that “practices still need to be connected to their patient population. By going remote, we are seeing volumes and revenues, albeit with limitations created by the crisis. One area we’re helping with is provider utilization, helping to determine whether resources need to be shifted to different areas to provide the care patients currently need.”
Patient risk scoring
Patient risk scoring is dramatically enabled by healthcare data analytics, helping medical practitioners look at specific markers across their patient population to identifying those who are most at risk relative to COVID-19 exposure. Using risk factors identified by the Center for Disease Control (CDC), healthcare analytics can help identify and flag at-risk patients based on co-morbidities such as asthma, COPD, etc., creating outreach campaigns to check on their health and well-being. “This can help providers stay connected to those who are at the highest risk in this COVID-19 environment, making sure they are okay and intervening if they need help.”
Armed with this information, Kobe showed a client example where significant volumes of patients were transitioned to telehealth, detailing the number of encounters, which included preventive sessions to monitor those with multiple risk factors. “This organization increased telehealth encounters in one month by 40 percent,” he said, “an amazing transition that was done very quickly to ensure continuity of care.”
In the era of COVID-19, Kobe explained that historical physician practice performance does not project future performance, because so many factors have changed relative to the pandemic. “Right now, we’re helping our clients look at what’s happening daily, and we are using trends to project forward. All of this is aimed at understanding where the revenue is coming from now and what it will look like in the future.”
In this sense, he said the main volume metrics still apply when measuring physician productivity relative to compensation. “Negotiated payor mix, rates and chargemaster costs don’t change, so it is still all about volume and use of the physician’s time. From a performance improvement standpoint, the focus should be on how to utilize the physicians’ time most effectively, ensuring they can take care of as many patients as they can and provide the best possible care.”
Breaking down barriers
Getting to optimal physician performance is all about breaking down barriers that exist in the practice. At the top of the list are scheduling challenges, followed by contractual and market barriers.
“Scheduling is getting very interesting as we move forward into telehealth and remote visit types,” Kobe explained. “We aren’t entirely sure how this will affect the schedule. Providers report that they are spending as much time helping patients get online as they are actually providing support, so there’s a lot of training needed longer term to get patients and providers comfortable with the approach.”
Ultimately, it is anticipated that the industry will move to a more blended model of telehealth and live patient visits, suggesting the need for healthcare data to drive entirely new workflows.
Creating action plans
Action plans post-COVID-19 will likely hinge on identifying opportunities to improve relative to the crisis, with cost-cutting being the primary focus in the interim. “Right now, it is all about determining what is absolutely necessary for our practices to perform – and what is not. This crisis has pushed us through an accelerated performance improvement process, forcing us to focus on what’s most critical. Pre-COVID, we might have been looking at a massive report with 80 metrics, now we’re focused on a few, with everything else considered noise.
“The big question is how to change behavior based on the data. During COVID-19 and beyond, the most important thing you can do is to spend your time on improvements – not just generating numbers in reports – so you’ll come out better as the industry recovers,” Kobe concluded.