5 Ways to Provide Quality Care to High-Need, High-Cost Patients | Optimum Perm

5 Ways to Provide Quality Care to High-Need, High-Cost Patients

As any good hospital leader or physician knows, it’s important to strive for optimal patient care. A hospital in Cleveland, Ohio, conducted “red flag” reports to measure patient care post-discharge and improve engagement. The results were surprising. About 64 patients a month didn’t make a follow-up appointment due to a variety of reasons, including lack of transportation and/or communication.

High-need, high-cost (HNHC) patients face a plethora of additional challenges, including undiagnosed or chronic medical conditions, repeated hospital visits, and economic struggles. Although this definition applies to only 5 percent of the U.S. population, HNHC patients account for 50 percent of healthcare costs.

Developing better quality care and properly addressing obstacles throughout recovery could help lower your hospital or health system’s costs and increase patient engagement. Since HNHC patients account for most costs, it’s logical for healthcare leaders to devise a plan to target their care optimization first. A focus group of HNHC patients offered the following suggestions for improvement:

Telemedicine. Patients were extremely open to the use of telemedicine. The convenience of using the service helped patients experience improved access to care. Additionally, the security of communicating directly with a provider helped eliminate some of the anxiety that preceded emergency room visits. By having a provider readily accessible, patients were more likely to seek education about their symptoms or health issues, making telemedicine a suitable substitute for a traditional visit.

Mail-order prescriptions. Sometimes patients encounter barriers that prevent them from picking up prescriptions. Patients applauded home prescription delivery, also mentioning that a larger refill supply helped them remain on track. Quite a few pharmacies are piloting automatic refills and home delivery, but respondents noted that these services should be better publicized and included in patient education.

Appointment scheduling and reminders. Even when transportation is available, patients sometimes need assistance with their day-to-day care. Care managers are an easy resource to trust and provide answers to patient questions. Even though the ROI of care management is still under review, the patients in the focus group fully supported its service.

In-home physical therapy and nursing services. Patients who had difficulty moving around post-operation or in general found this service an especially helpful transition after hospital stays.

Additional after-hours clinics. These additional clinics help decrease visits to the emergency department. Although after-hour clinics are not a new concept, patients felt that doctors and hospitals could do a better job of promoting these services and educating patients about when they might be a good alternative to an urgent care center or the ER.

While many of these solutions exist in various healthcare settings, hospitals and healthcare systems should ensure they are designating resources to strengthen their availability, reduce costs, and ultimately, enhance the patient experience.

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