Healthcare and Value Based Care in 2023
If you are thinking about how the business of healthcare and value based care in 2023, this article by John Lynn at Healthcare IT Today will give you perspective on what industry leaders think. Jon Gautch, Sr. Vice President of Engineering at AristaMD gave his opinion:
As a result of physician turnover, increasing care demands, and the impending recession, we’ll likely see more healthcare organizations prioritize cost management in 2023. Curbing rising healthcare costs has always been top of mind for the healthcare industry. Yet the macroeconomic turbulence expected next year will force companies to take an even closer look at how to lower overall healthcare costs while continuing to move towards value-based care and improve patient/provider satisfaction.
The recession will leave many patients in a difficult financial situation, likely resulting in delayed medical bills and elective surgeries. Yet, once nonelective treatment becomes unavoidable, we’ll then see a quick uptick in patient care, causing a strain and financial burden on our health systems. The slowdown, followed by the quick boost in care, will drive pressures on health organizations to manage costs and preserve revenue.
I predict this will present even more opportunity and demand for telehealth solutions, like eConsults, in addition to technology that can automate labor-intensive tasks and streamline traditionally manual processes. It will be a critical year for healthcare organizations to reduce the cost of care across the healthcare spectrum while not sacrificing patient outcomes.
Hear what other IT leaders in the industry had to say about the topic:
Jon Gautsch
Sr. Vice President of Engineering
Jon Gautsch, Sr. Vice President of Engineering, leads and directs our agile software team. He brings over several years of experience managing and architecting software engineering projects. Jon joined AristaMD following the acquisition of Preferral, a referral management, analytics and document routing company, which he founded in 2014.
Jon started his career by developing an innovative healthcare referral management tool that simplified and accelerated patient referrals. While he was attending The University of Notre Dame, Jon noticed his father, an orthopedic surgeon, still received referrals from doctors by phone and fax machine. This observation prompted him to begin writing code for software that would allow primary care physicians to search for specialists, match insurance plans, set appointments, and remind patients of those appointments. Jon served as the Chief Technology Officer of Preferral until January 2022. He has also developed and licensed proprietary technology to some of the largest healthcare informatics companies.
How online referral management boosts primary care revenue
Primary care practices are looking to online referral management applications to improve the referral process and grow revenue as well as support patient healthcare and value based care.A study of 105 million referrals by the Archives of Internal Medicine found that only about half of referrals resulted in a visit to a specialist. This means roughly 50% of the time, patients fail to receive the care they need, and specialists do not capture the most revenue.
There are several reasons why patient referral and follow-up is a complex, manual and time-consuming process. The referral coordinator must:
- Determining which specialists work with a patient’s insurance
- Accommodating patient preferences around the location
- Identify if the appropriate sub-specialty is available within the practice
- Confirm that appointments are available soon at the selected specialist
One study showed that less than 50% of specialty care remained within a health system — leading to network leakage. While some leakage is to be expected, most of it can be avoided by using an online referral system.