Medicare reimbursement reform measures such as the Merit-Based Incentive Payment System (MIPS) are creating an urgent problem for value-based health systems. Enterprise data systems can take years to assemble and implement. But an agile, laboratory-based analytics platform can be up and running much more quickly, making it an ideal solution for small to mid-sized hospitals and health systems.
The laboratory has more touch points with patients than any other department or unit in healthcare. Each of those medical touch points is recorded in the laboratory information system (LIS), and that data can be matched with data from other systems to see correlations and arrive at actionable insights.
Moreover, lab data has tremendously predictive potency, and is superior for predicting disease progression and hospital readmissions. This is especially important today because under MIPS, 30% of the composite provider score will be based on cost measures based on not only total cost of care, but also care episodes by patient condition groups.
Let’s look at the example of chronic kidney disease (CKD).
Approximately 13% of American adults have CKD. For those over the age of 65, the number climbs to nearly 45%. For adults over 30, the lifetime risk of CKD is now greater than 50%, and that number is expected to rise sharply within the next 15 years. People with CKD are at increased risk for complications like heart disease and end-stage renal disease (ESRD), or kidney failure, in other words.
While there are proven therapies to improve outcomes in CKD patients, they can be risky and costly. Current methods of predicting which CKD patients will progress to ESRD aren’t very accurate, which causes patients receiving a CKD diagnosis to experience high levels of anxiety and, often, suboptimal medical care. Without accurate risk prediction, many patients are over-treated, which wastes healthcare resources and negatively impacts outcomes. On the other hand, there are many patients who receive inadequate care, restricting treatment options to only the most expensive and least desirable interventions.
Analytics solutions exist for improving the clinical and economic outcomes of your CKD population. Viewics CKD Management™, for example, delivers a personalized patient risk score, automated care management recommendations for primary care and nephrology clinicians, and customized patient education reports directly to the electronic medical record (EMR).
With MIPS right around the corner, a vast swath of the healthcare sector has an urgent need for advanced analytics. The laboratory has the power and the tools, and is very well positioned to serve this need. By using laboratory-driven analytics solutions, hospitals and health systems can reduce costs, integrate and coordinate care delivery, and prepare themselves for the coming payment overhaul. Learn more in our white paper, Agile Analytics: The Key to Surviving and Thriving After the Medicare Tipping Point.