Before the pandemic, many healthcare organizations worked mostly with a fee-for-service (FFS) model. In this system, providers were paid for each test, visit, or procedure they did. While this rewarded the number of services, it did not always lead to better health results.
Now, there is a growing move to value-based care (VBC), where the focus is on the quality and success of care given. VBC pays healthcare providers for better patient health and lower costs. Patient engagement is a main part of this change. The Agency for Healthcare Research and Quality says patient engagement means patients want and can take part in their own care. When patients are involved, they take better care of their health, go to the hospital less, use fewer medicines, and have a lower chance of getting sick.
This way of care means healthcare practices have to do more than just treat illnesses. Providers must now learn about different patient groups, including their backgrounds, cultures, and social factors that affect health. Patient engagement plans need to change based on these things. For example, ways to communicate vary by age, ethnicity, and living situation. One method does not work for everyone anymore.
The COVID-19 pandemic sped up many of these changes in patient engagement, especially shifting from in-person visits to remote care. Robert Fields, M.D., from Mount Sinai Health System, said that face-to-face care was not possible for many chronic and vulnerable patients during the pandemic. Instead, care had to be more active and done remotely.
Mount Sinai had front desk workers call their most vulnerable patients, like those who had trouble getting food or had mental health concerns. This helped keep care going and checked on how patients were doing. This active contact helped lower emergency room visits and hospital stays for those patients. Mount Sinai also worked more with community groups and used health workers to help with patient contact and support.
Changing to remote outreach was a major change in patient engagement. Waiting for patients to call first was risky since many were scared and had trouble moving around during the pandemic. Direct calls helped patients stay connected to care and helped with social problems that affect health.
Strong patient engagement helps overall population health. When patients take part in their care, health organizations can better manage long-term illnesses, lower hospital visits, and reduce health costs.
Patients who are involved make hospitals less crowded and improve public health numbers. Knowing the different needs of people helps health groups use resources better. For example, communication for older adults who are not good with technology is different from that for younger, tech-savvy patients.
Besides communication, dealing with social health factors is important for patient engagement. Problems like money issues, not having enough food, mental health struggles, and unstable housing affect how well patients follow care plans. Health systems that plan for these problems in patient engagement improve health for both individuals and the community.
Another part of patient engagement is the health worker’s well-being. Even before COVID-19, many nurses, doctors, and health workers felt burned out. The pandemic made this worse and more health workers thought about quitting. Stress and workers leaving cause problems for health groups trying to keep good patient engagement.
In October 2022, the National Academy of Medicine (NAM) started the National Plan for Health Workforce Well-Being. The plan wants to reduce burnout and make work better for health workers. It suggests creating good work environments, giving mental health support, cutting down paperwork, and using health technology to make work easier.
A key part is lowering the time spent on documentation and tasks that take up a lot of time. Too much paperwork and rules use health workers’ time and can make patient visits worse. Easy-to-use technology that works well with other systems can help with this.
Supporting health workers’ well-being helps patient engagement too. Healthy and motivated workers give better care and communicate better with patients.
The COVID-19 pandemic made many health groups use digital health tools faster. Telehealth visits, automatic appointment reminders, remote patient monitors, and online portals are now common. These tools make care easier to get and often cheaper, but they can also cause problems with fairness.
Studies show a gap in digital skills and access, especially in rich countries like the U.S. Older adults, low-income families, and people not good with technology face problems using these tools. If these problems are not solved, health differences can get worse instead of better.
For example, patients without good internet or computer skills may not be able to use telehealth or automated messages well. This shows the need for plans that match patients’ real situations and skills. Digital health policies should focus on fairness so all patients can join remote care and stay involved.
Using tools like the eHealth equity framework helps people study and fix these gaps. Health groups should work with community groups and change digital plans to close these gaps.
One growing area in patient engagement is artificial intelligence (AI) and workflow automation. AI tools can help medical offices handle many calls, book appointments, answer questions, and send patients to the right care quickly. For example, Simbo AI uses AI for phone answering and front-office help.
By letting AI handle routine calls and contacts, staff can spend more time on patients with harder needs. AI systems can send messages that fit the patient’s age, history, or health problems. This makes communication more useful and timely.
AI can also check patient questions, send calls to the right person, and handle appointment reminders or changes. Automation cuts down wait time and missed calls, which often make patients unhappy and less involved.
Another good point is that AI can work with electronic health records and management systems to manage billing and paperwork. This saves staff time and helps them give better care.
For office managers and IT staff, using AI like Simbo AI can help move to value-based care. It improves patient contact and helps control costs. Automation also helps with proactive patient contact like Mount Sinai did during the pandemic, keeping at-risk patients connected to care.
Medical practice administrators and owners in the U.S. need to plan carefully and spend on technology that helps both patients and staff.
The COVID-19 pandemic showed problems in usual healthcare methods but also sped up using remote and digital care. This change fits well with value-based care and managing population health. Health groups that use technology like AI and automation while caring for workers are better set to improve patient results and manage costs long term.
Value-based care (VBC) is a healthcare delivery model that aims to improve patient outcomes and reduce healthcare costs by incentivizing providers to deliver high-quality, patient-centered care rather than focusing on the quantity of services provided.
Patient engagement is crucial in value-based care as actively involved patients tend to experience better health outcomes, lower costs, and fewer hospitalizations, thus supporting the overall goals of VBC.
Benefits of patient engagement include improved health outcomes, reduced hospitalizations, less reliance on medications, decreased disease risks and infections, and lower healthcare costs.
Organizations can enhance patient engagement by understanding patient demographics, adjusting communication strategies based on age, race, and community context, and leveraging motivational psychology.
Improved patient engagement positively impacts population health by lowering costs and enhancing individual health outcomes, which collectively contribute to better health metrics for the community.
The pandemic prompted healthcare organizations to adapt their engagement strategies, shifting from in-person to remote care, and prioritizing outreach to vulnerable populations.
Social determinants of health significantly influence patient engagement by affecting access to care and requiring tailored strategies that account for unique community needs.
Understanding community needs allows healthcare organizations to provide targeted interventions and resources, improving access and enhancing patient engagement across diverse populations.
Effective revenue cycle management is essential in value-based care as it ensures financial sustainability, improves reimbursement processes, and supports the overall efficiency of healthcare organizations.
Healthcare consultants provide expert guidance on reimbursement, clinical documentation, and revenue cycle management, facilitating smoother transitions to value-based care models for organizations of all sizes.
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