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At NextGen Healthcare, our mission is to help practices like yours achieve better healthcare outcomes for all. Sounds great—but what will make these lofty words a meaningful reality? As a health IT professional and physician, this question matters a great deal to me.

What conditions are necessary for my colleagues and me to become effective partners with the medical practices we serve in ameliorating the pain points of a troubled healthcare system? A recent study suggests that the answer comes down to two key factors.

A motivating force

Change isn’t easy or always welcome. The first necessary ingredient is a motivating force. Medical practice administrators, physicians, and staff need good reasons to accept and implement changes.

Motivation in healthcare comes from one of two sources—the drive to improve patient well-being and quality of life or the desire for financial survival and growth. Right now, economic forces such as cost pressure and consolidation, are pounding at the doorway of independent medical practice.

Medicare, Medicaid, and private health insurance companies continue to push for payment based on quality and value of care rather than only reward the volume of services delivered. The pace of change remains slow but the financial pressure for medical practices to adapt is inexorable if not yet urgent. 

Technology to facilitate measurement

A motivating force by itself isn’t enough. Even as they come to terms with the plodding inevitability of new payment models, medical practices must be able to measure their own performance to manage the gradual but far-reaching shift in their business environment. This is the point where health IT enters the picture.

First, to set goals for the future, medical practices must be able to measure where they stand today. Then, they will need a way to determine the impact of new policies and practices on clinical outcomes and financial performance. In the complex clinical and financial world of contemporary healthcare, this requires access to powerful, precise technology.

A real-world example

To show how this works in real life, consider a study by HEALTHeLINK, a health information exchange (HIE). This study looked at four groups of practices in the Western New York region with similar patient populations. Three of these four groups were enrolled in the  Comprehensive Primary Care Plus program—a program established by the Centers for Medicare and Medicaid Services (CMS) to improve quality, access, and efficiency of primary care.

One group of practices enrolled in the Comprehensive Primary Care Plus program also utilized NextGen® Population Health, a solution that provides medical practices a clear view into their patient population with aggregated, multi-source data and an easy-to-navigate visual display. This group out-performed all other groups in the study. The results are remarkable and speak for themselves.

  • 24.1% reduction in hospital admissions rate
  • 30.4% reduction in re-admission rate
  • 32.7% reduction in hospital length of stay

This group of practices had both (1) a motivating force for change—enrollment in a value-based care incentive program—and (2) a tool to measure their performance, NextGen Population Health.

The challenges ahead

It is gratifying to see these results achieved with NextGen Population Health. For independent medical practices to succeed under new payment models, they need access to technology solutions that will enable them to manage and meet new demands for cost-control and quality and document their achievements, so they receive their proper financial reward. Technology can also help level the playing field with third-party payers and large healthcare systems.

However, challenges are inevitable on the road ahead. There is always the risk in a value-based framework that excessive focus on the cost component of care will harm the doctor-patient relationship and ultimately patient well-being. Also, physicians are being asked to take on more risk—but the reality is that our control over patient compliance—which largely determines outcomes—is limited. How can value-based care be implemented in a way that is fair to physicians who are being asked to take on financial risk for factors outside our control?

What is certain is that health IT has a huge role to play in the future of independent medical practice. But success will not depend on technology alone but the interplay of technology with economic, social, and human factors.  

For more about the HEALTHeLINK study, check out this press release

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Dr. Jennifer Bolduc
Vice President of Population Health, NextGen Healthcare
Dr. Jennifer Bolduc is Vice President of Population Health at NextGen Healthcare and is board-certified in clinical informatics and pediatrics. She serves as a population health subject matter expert for clients and across the company to support product development and integration, regulatory compliance, education and training, marketing and sales. Areas of focus include care management, clinical...