11:10 - 11:15 amSunday, September 18
Upper Lobby
Closing the gap: how technology empowers your frontline to improve health outcomes
Upper Lobby
Closing the gap: how technology empowers your frontline to improve health outcomes
Clover Health
Elderly care coordination is one of the biggest challenges facing modern medicine. It can lead to poor patient outcomes and costly, preventable hospitalizations. At the same time we are struggling to make... Read more

Description

Elderly care coordination is one of the biggest challenges facing modern medicine. It can lead to poor patient outcomes and costly, preventable hospitalizations. At the same time we are struggling to make sense of the increasing yet fragmented volumes of patient data. These factors hinder our ability to identify and coordinate care for our most high risk patients. What’s needed is a new model that leverages technology to empower everyone on the care continuum to act in the patient’s interest.

Whilst payers may be the most incentivised to coordinate care, they have traditionally had limited abilities to act. Most of the current strategies center on focusing efforts on the costliest 5% of members. Yet with elderly members, by the time they are on the payer’s radar, their health may already extremely poor and any intervention is therefore of limited impact.

At Clover, we believe in taking responsibility in bridging gaps in care. As the payer, we can utilize data from primary care physicians, labs, pharmacies, home visits and more to create a holistic profile of each member. From this vantage point, we are changing the relationship we have with our members from one that is transactional to one where we active working to improve their health. We also align with physicians by compensating them to provide high touch coordination and by supporting their efforts with our data.

Better predictive modeling allows us to accurately identify members with potentially undiagnosed illnesses, poorly managed chronic conditions and social issues before they escalate to an ER visit. Our technology then empowers our front-line staff of social workers, nurse practitioners as well as our members’ own primary care physicians to intervene and prevent a serious medical episode. This can range from home testing for congestive heart failure to helping members get financial assistance for drugs, improving their adherence.

At its core, our team has created an operational and technology stack to respond quickly in the interest of our members’ health. New information is ingested from many sources in real-time, allowing us to constantly improve our models. On the ground, we’ve designed a culture where anyone touching the member can make an impact on closing care gaps. Be it a nurse practitioner or a call center agent, they all play a role in identifying at risk members and helping them get the care they need.

During this session you will learn about the reasons why care coordination is a major challenge to the traditional healthcare system. You will also hear examples of how focusing on “deep data” rather than “big data” can create better risk models. Finally, you will leave with a picture of how technology, physician-payer alignment and operational culture can be combined to close gaps in care and improve health outcomes.

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