Why is provider engagement so important?

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 both the health plan and the provider practices.

Three essential elements of provider engagement

Increased adoption of gap-closure activities

Given the right tools, providers can use point-of-care decision support to close 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.

Additional strategies 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. When health plans provide technologies that unlock data-driven insights, they empower providers to maximize effectiveness and care quality. Working with providers’ time constraints, health plans offering training and support enable greater insight and actions indicated from these platforms.
  • 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 and goals to providers leveraging intuitive, data-driven software are able to achieve efficient, actionable provider engagement. Helpful tools like Converged Provider Enablement deliver insights around patient care quality, provider performance, and disease burden documentation gaps. Driving greater clinical quality outcomes and financial performance, Converged Provider Enablement also informs each patient encounter to reduce administrative burden and increase efficiencies for providers and payers alike.

To learn more about Converged Provider Enablement, view this on-demand webinar.

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