The importance of provider engagement

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Enhancing provider engagement can have a dramatic impact on health plan performance. Recent studies show that health plans find that involving providers leads to improved clinical outcomes and quality ratings, member retention, and overall efficiency. Achieving meaningful provider engagement requires alignment between the quality and economic goals of the health plan and the quality and economic goals of the provider practices. The essential elements to provider engagement with the goal to improve quality include the following:

Increased adoption of gap-closure activities; Given the right tools, providers can use point-of-care decision support to close preventive care gaps. These platforms give providers full access into a member’s profile, including prior assessments, documentation, and care-gap reports. This real-time information helps providers have a more comprehensive view of their patients’ health status to empower gap closure.

Improved interoperability; A complete view of the patient’s prior care is essential to improving care and reducing unnecessary treatment. The industry will continue to see improvements here due to the interoperability rule changes indicated in the 21st Century Cures Act. Providers must be able to quickly view medical records, regardless of where they are located and what electronic health record (EHR) they were created in.

Use of data-driven best practices; Knowing the right questions to ask and being able to leverage data-driven insights leads to more targeted interventions for patients and more efficient use of a provider’s time. It also decreases unnecessary tests and treatments, increasing patient satisfaction and health plan efficiencies and performance.

The following are several important best practices for achieving provider engagement:

Clear communication. Successful health plans clearly communicate both the complete vision and the specific steps needed to achieve their goals.

Targeted outreach. Savvy health plans have a system for regular, targeted outreach to providers that will remind them of important dates and milestones and encourages participation. Health plans can take a multi-channel approach and use the preferred communication channel that each provider indicates.

Decision-support tools and interoperability. Data underpins every potential improvement for providers. A data analytics tool is essential is the best software available. This software empowers the providers to maximize their effectiveness and care quality.

Provider incentives. Changing provider practice patterns is a difficult task, but health plans using the right incentives are achieving goal alignment and seeing improved outcomes.

Health plans that consistently communicate a clear vision with specific goals to providers leveraging intuitive technology with data-driven insights are able to achieve efficient, actionable provider engagement. Helpful tools like Ensure Data Solutions software deliver actionable insights around patient care quality, provider performance, utilization, and disease burden documentation gaps.  Driving greater clinical quality outcomes and financial performance.