To support value-based care strategies, Utica Park Clinic (UPC) wanted to help healthcare providers connect with patients using engagement tools that could seamlessly integrate with its Epic EHR software.
5% – 8% no-show rateswith automated, persistent multimodal appointment reminders
30% boost in annual patient visitsand 50% increase in providers, enabled in part by greater productivity
Helps attract new patientswith high quality ratings for value-based plans such as Medicare Advantage
Business challenge story
Proactive, targeted patient engagement
UPC, one of Oklahoma’s largest multispecialty physician groups, is embracing value-based care, which is designed to improve patient outcomes and reduce costs by delivering the right care at the right time. Part of Hillcrest Healthcare System, UPC providers practice across the greater Tulsa metropolitan area and work with the eight Hillcrest Healthcare System hospitals. UPC’s growth and success requires careful orchestration of its patient engagement and population health strategies.
“Our clinical charges are to better prepare our practices for population health management so that we can better partner with our health plans and better align with our hospitals to provide quality care,” explains Dr. Jeffrey Galles, Chief Medical Officer (CMO) and a practicing physician at UPC.
When Hillcrest announced plans to adopt a new EHR software suite, Dr. Galles became concerned that the EHR patient portal module couldn’t meet all of UPC’s needs. “Patients must enroll through the online portal, but many never take that step,” he explains. “It can take years to grow your EHR portal patient database.” Even if individuals do enroll, he adds, a large percentage don’t actively use the tool and miss appointment reminders and other important communications. With 650,000 annual patient visits, UPC needed alternative ways to engage patients and minimize no-show rates.
The EHR portal also couldn’t provide UPC with the robust capabilities required to successfully support not only plans that compensate providers based on a traditional fee-for-service (FFS) model but also newer, pay-for-performance plans such as Medicare Advantage. For example, providers needed to quickly identify gaps in care and perform outreach using up-to-date protocols, especially for individuals with complex, chronic conditions that require consistent, frequent care. The organization also had to be able to accurately measure and report on the quality of care within and across patient populations.
EHR enhanced with intuitive Phytel tools
Dr. Galles had already used Phytel SaaS solutions from Watson Health with UPC’s previous EHR platform for several years. He understood firsthand the solutions’ role in fostering clinical and operational success. To make a winning business case to Hillcrest executives for combining Epic EHR software with Phytel tools, he conducted a gap analysis that compared the EHR patient portal with Phytel functionality across several categories. The results revealed multiple areas in which the EHR’s capabilities failed to meet UPC’s needs — from patient registry setup to maintaining scripts and other content to ROI analysis and reporting.
Watson Health took the lead in rapidly and seamlessly integrating the Phytel solutions with UPC’s EHR system prior to launch. “Our IT team was so taxed with the process of rolling out the EHR that they were not able to help Watson Health,” comments Dr. Galles. “Watson Health did all of the implementation with minimal assistance from us. Right off the bat, that was very important.”
During the transition period of six months, UPC avoided higher no-show rates. Relying on UPC’s established Phytel patient database, clinics continued to send appointment reminders to existing patients. They could also quickly enroll new patients because the Phytel solution requires only an individual’s phone number for enrollment. UPC used its Phytel reporting database to validate the accuracy of quality measures captured in its EHR system.
UPC clinics can now use Phytel tools within their EHR workflows to drive quality of care within and across patient populations. With the Phytel Remind solution, they can automatically send customized voice, text and email appointment reminders and confirmations. With the Phytel Outreach solution, they can proactively identify patients who are recommended for care and then initiate automated, customizable notifications for follow-up visits, tests and procedures. They can also persist in sending communications using a multimodal approach that remains activated until the patient responds. Backed by automated solutions, staff can have more time to personally reach out to less engaged, higher-risk patient populations.
In addition, UPC takes advantage of more than 20 of the approximately 200 prebuilt, evidence-based protocols in the Phytel Outreach solution. With the protocols, which run continuously, the organization sets expectations for physicians, advanced practice providers and patients around recommended care, including frequency and type. These automated protocols prove especially important in addressing care gaps for individuals with diabetes, hypertension and other high-risk medical conditions. They also help ensure patients receive appropriate preventive care, including immunizations and colon cancer screenings. “Our patients come to depend on these automated reminders. They know they’re going to get a call, and they can count on that call,” says Dr. Galles.
With Phytel tools, UPC can also closely monitor and report on quality metrics for its value-based care initiatives. In 2012, the healthcare group began participating in the Comprehensive Primary Care (CPC) initiative, launched by the Centers for Medicare & Medicaid Services (CMS) to strengthen primary care through better care coordination and other financial incentives. With the comprehensive database and reporting capabilities of the Phytel Outreach solution, UPC can meet CPC metric requirements and fuel its success in the program.
UPC can also better track its quality metrics for Medicare Advantage plans. The Medicare STAR Rating System rates providers on a scale of one to five stars based on quality metrics in five categories, including preventive and wellness services and chronic condition management. The higher UPC’s STAR ratings, the more funds the organization receives for services delivered to its 20,000 Medicare Advantage members.
“That’s where our market is moving, so with Phytel tools, we can dial in our patient engagement strategies around the Medicare STAR metrics,” Dr. Galles explains. “We keep our providers and our patients engaged at a level that they’re hitting on all the different metrics that we’re challenged with reporting.”
Five-star results drive growth
UPC’s ongoing relationship with Watson Health helped it achieve results in four key areas. First, it helped it embrace innovative approaches to healthcare and become a more data-driven, quality-focused healthcare provider. The healthcare group measures the benefits of using Phytel tools in multiple ways. First, its practices maintain efficiency with low no-show rates, ranging from 5% – 8%, depending on the specialty. These low rates also drive patient volumes for FFS revenue streams.
Second, UPC can more easily build on its growth and leadership position. Since 2015, the organization boosted its annual patient visit volumes by approximately 30% and its number of practicing providers by 50%. With Phytel tools, UPC enhances productivity, quickly scales to accommodate patient registries for new practices, and saves costs associated with manually building and maintaining outreach protocols.
Third, UPC can attract new patients and improve patient outcomes and satisfaction with high quality metrics. For example, the organization has achieved pneumococcal vaccination rates of 80.1%, breast cancer screening rates of 74.5% and colon cancer screening rates of 73.1%. Among UPC patients with diabetes, blood glucose control rates, determined by A1C tests with a value of less than 9%, have reached 84%. In addition, because of UPC’s success, Hillcrest Healthcare System has begun to use the Phytel software suite with its cardiology group — Oklahoma Heart Institute (OHI) — and in several outpatient radiology scheduling departments.
Finally, UPC consistently achieves four- and five-star ratings within the Medicare STAR system. It also scores high ratings for commercial pay-for-performance plans. “We see our value-based revenues continuing to grow by 30% – 40% annually over the past three to four years, which supports our population health strategies, helps our healthcare system financially and allows us to be a community leader in this arena,” says Dr. Galles.
Utica Park Clinic
Based in the US in Tulsa, UPC and OHI operate more than 70 clinics with approximately 370 primary and specialty care providers who deliver a comprehensive range of medical services to northeast Oklahoma residents. As part of Hillcrest Healthcare System, UPC also works with OHI and 8 regional hospitals. Hillcrest’s parent company, Ardent Health Services, is a for-profit healthcare organization based in Nashville, Tennessee, with more than 30 hospitals nationwide.
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