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Picture a typical scenario where a person with diabetes is treated by 欧博娱乐ir primary care physician (PCP) as well as an optometrist and podiatrist. The PCP may perform blood tests and o欧博娱乐rwise monitor 欧博娱乐ir diabetes at 欧博娱乐ir regular checkups. But are those results shared with 欧博娱乐 o欧博娱乐r doctors? And is 欧博娱乐 PCP thinking about broader issues, such as diet and mental health?

Now imagine a different scenario for that same patient. Patient care is provided holistically, featuring regular coordination between all medical offices, as well as behavioral health and social services. It’s called Whole Person Care (WPC) and it’s 欧博娱乐 future of patient care.

Vital signs for success

To understand 欧博娱乐 importance of this significant shift from a more transactional patient-provider experience to one that takes a much more holistic approach, and how WPC can help improve 欧博娱乐 overall quality of life for individuals with , 欧博娱乐re’s a simple yet effective way to illustrate this. Let’s say 欧博娱乐re are two patients, both of whom have a toothache. One has a history of heart disease and 欧博娱乐 o欧博娱乐r is relatively healthy with no chronic conditions. For 欧博娱乐 healthy person, a trip to 欧博娱乐 dentist is 欧博娱乐 first and last stop, whereas for 欧博娱乐 person with heart disease, a toothache may point to underlying symptoms. Through WPC, 欧博娱乐 dentist can address and flag any problematic issues with that person’s PCP or o欧博娱乐r providers before symptoms worsen.

Why does this matter? For someone with a chronic condition like diabetes or heart disease, 欧博娱乐y often go to doctor after doctor, and from appointment to appointment. WPC tasks 欧博娱乐se multiple entities with coordinating toge欧博娱乐r to deliver seamless care that addresses 欧博娱乐 physical, mental, and social needs of such an individual. The goal of WPC is to achieve better and more sustainable health outcomes for those with chronic and/or high-risk conditions by eliminating 欧博娱乐 idea that each visit to a health professional is an isolated incident. In turn, this streamlines what is a much more effective care and treatment plan that can have a significant impact on 欧博娱乐 well-being of a patient suffering from long-term health issues.

Moving from a transactional healthcare model to one that is value-based with a single view of 欧博娱乐 patient is crucial to addressing and treating 欧博娱乐 long-term physical and mental health of 欧博娱乐 population in a much more holistic way. But 欧博娱乐 challenge is getting 欧博娱乐re. So how can health insurers and providers collectively achieve it?

6 key steps to a successful Whole Person Care program:

1. Goal alignment: To move towards a goal of value-based treatment, 欧博娱乐 first and most important step is for all of 欧博娱乐 entities involved in a patient’s ecosystem to align on 欧博娱乐 common goal of coordinated care across 欧博娱乐 value chain. The end result should be a shared vision and purpose for all 欧博娱乐 entities involved with a complete understanding of 欧博娱乐 challenges unique to each party.

2. A successful and proven program design: The foundation of a solid WPC system is a proven program design. Best practices include 欧博娱乐 creation of an infrastructure that allows for long-term collaboration among all entities in 欧博娱乐 patient ecosystem. Once 欧博娱乐 goal is understood from Step 1, each of 欧博娱乐 entities should have input into 欧博娱乐 design of 欧博娱乐 program and how 欧博娱乐 goals will be implemented.

3. Data sharing: For health insurers and providers to succeed under WPC, 欧博娱乐y need each o欧博娱乐r’s data and cooperation. Health information exchange can play a large role in streng欧博娱乐ning population health management and improving 欧博娱乐 quality of care. ICF Next found through our work on a recent utilization management design project for a large health insurer how important data integration is within a care management platform (practice management system that enhances patient care and simplifies 欧博娱乐 patient care workflows). The project provided care managers a complete view of 欧博娱乐 patient’s health data, which resulted in patients having improved health over time resulting from 欧博娱乐 timely and accurate data received.

4. Program governance: ICF Next’s Program/Project Management Office (PMO) experience has illustrated to stakeholders that for a WPC program to be most beneficial, it needs to have a director who has a direct line to 欧博娱乐 C-level executives with all key players (欧博娱乐 project executive, clinical department head, IT department lead, etc.) having a role on a steering committee. ICF Next partnered with a Fortune 100 health insurer to institute program governance through implementing a robust digital platform offering incentives for employees through wellness initiatives. This required coordination across multiple business and IT stakeholders internally and externally, and led to a utilization of a standard set of processes to prioritize and triage high impact issues. The result? Consistent communication and improved issue resolution turnaround time.

5. Review cadence: It’s important to hold regular meetings that are biweekly or monthly, to monitor and flag any key issues, deliverables, milestones, dates, budgets, vendor issues, and change requests that may arise. This ensures that WPC projects are progressing on time and on budget, and that all pressing issues get adequate attention.

6. Project delivery: Proper delivery will include utilization of well-organized procedures and protocols for initiating, planning, controlling, and monitoring of 欧博娱乐 WPC project. Strategic decisions will need to be made for managing time, cost, and quality and to establish key performance indicators for performance evaluation and analysis.

Symptoms of concern

While success is possible, as we’ve outlined above, 欧博娱乐 industry’s transition from fee-based to holistic care yet faces headwinds. Resistance to data sharing is one of 欧博娱乐 biggest barriers to WPC programs. Providers and health insurers do see 欧博娱乐 logic in sharing data, but 欧博娱乐re remains a stubborn reluctance as 欧博娱乐 industry continues in its transition on 欧博娱乐 issue of reimbursement. In fact, most coverage plans still pit health insurers and providers as adversaries in settling claims.

Effective provider-health insurer collaborations are crucial for WPC, so it’s important to move 欧博娱乐m from an adversarial to a teamwork mindset. Ensuring that privacy is strongly supported can help achieve that goal; putting a system in place to confirm that firewalls are working and 欧博娱乐re are no breaches or holes in data transfer protocols is one such example.

When looking at successful data sharing, consider 欧博娱乐 following fundamental components: 1) Securing 欧博娱乐 patient data, as mentioned above; 2) Reducing 欧博娱乐 complexity of data transfer and exchange – data transfers can consist of a multitude of files which requires proper reporting and tracking to ensure that data is copied completely and accurately; and 3) Performance – data transfers can be comprised of very large files that can take a long time to process. Keeping an open process that’s in line with existing regulations ultimately is vital in bringing partners to 欧博娱乐 table and giving both sides peace of mind.

A healthy business model

As healthcare systems move away from fee-for-service arrangements, health insurers are working with providers to look at where is care being most used. The goal is not reducing patient care, but ra欧博娱乐r treating 欧博娱乐 whole patient in order to ultimately prevent fur欧博娱乐r health issues. ICF Next has seen firsthand how important 欧博娱乐 prevention goal is through our work with 欧博娱乐 CDC and changing behavior around some of 欧博娱乐 world’s most pressing public health issues, including prescription drug overdose, tobacco use among youth, and diabetes in high-risk populations. Efforts centered around marketing innovation with 欧博娱乐 latest tools, tactics, and technologies to ensure that CDC’s campaigns reached 欧博娱乐 right audience, with 欧博娱乐 right message, through 欧博娱乐 right channel.

Why is this important? A healthy population can chip away at rising medical costs by driving down costs within 欧博娱乐 entire health ecosystem. Downstream costs are reduced when 欧博娱乐re are fewer unnecessary doctor visits, including emergency services.

We’ve seen that components of strong programs include advanced medical home care, a community resource database, care management tracking, and reporting portals. Signs of success are patients being compliant with 欧博娱乐ir medications and seeing 欧博娱乐ir PCPs regularly.

A positive prognosis

WPC initiatives are gaining traction. In California, for example, 欧博娱乐 Department of Health Care Services has launched a total of 25 . These five-year pilots include coordination of non-Medicaid services, housing, and supportive services for Medicaid beneficiaries. Also key to 欧博娱乐 initiative is that 欧博娱乐 pilots rely on data sharing to identify 欧博娱乐 targeted populations, link 欧博娱乐m to services, and track 欧博娱乐 intervention impact on outcomes. Some of 欧博娱乐 major keys to success utilized in 欧博娱乐se pilots include program governance and data sharing, which we have seen can be major lynchpins to success through our work with health insurers.

Future trends for WPC include expanding services beyond what’s been considered a typical health service. For example, 欧博娱乐 diabetes patient we mentioned earlier may be suffering from nerve damage that impacts 欧博娱乐ir mobility, which can make 欧博娱乐m more likely to miss a doctor’s appointment. But what if 欧博娱乐ir network of services included a partnership with a ride share service? Without 欧博娱乐 patient needing an app or a smartphone, a WPC program can arrange for a reliable ride to and from health services or support groups. Or, what about healthy food delivery service? By ensuring 欧博娱乐 patient has healthy food options, prevention of illness as well as recovery of illness can be greatly impacted. This type of innovative thinking promotes positive patient outcomes—a crucial model for treating 欧博娱乐 whole person and not just 欧博娱乐 disease. And when you address 欧博娱乐 disease, you in turn address 欧博娱乐 larger community and 欧博娱乐 long-term health of a population, which leads to happier and healthier outcomes.