By Brian Bamberger, Life Sciences Practice Lead
It seems that quality is king these days when it comes to improving patient care and outcomes while reducing costs. Payers and providers are expected to view use of clinical quality guidelines and best practices as central to their quality and value-based reimbursement efforts.
This is easier said than done. Adoption continues to be low, despite the proliferation of guidelines and best practices and widespread dissemination of research on their positive impacts. This represents a huge opportunity for managed markets teams to help accounts wade through the noise and disseminate credible information to providers so they can make more informed decisions, standardize care and improve quality.
The need is there. According to the Agency for Healthcare Quality and Research (AHRQ), there is a disturbing gap in quality – namely, the difference between present treatment success rates and those thought to be achievable through the use of best practices and clinical guidelines. This gap has been documented for some time. For example, a 2003 Institute of Medicine report identifies 20 diseases and clinical conditions that may be significantly improved or effectively managed by using best practice treatment guidelines.
As a result, patients suffer needlessly – and sometimes even die – from medical conditions that could be treated successfully if guidelines and best practices were followed. Meanwhile, public and private payers (and taxpayers) are stuck with the unnecessary bills. In addition, providers such as accountable care organizations and integrated delivery networks are being judged on their quality metrics and outcomes, which figure heavily in their reimbursement.
While this is a frustrating situation, managed markets teams can help bridge the gap because their pharmaceutical companies are sitting on a wealth of data and expertise on guidelines, both of which can be brought to bear. They also are uniquely positioned to overcome provider-centered barriers to adoption of evidence-based care. For example:
In short, managed markets teams can be an invaluable resource in identifying best practices, best EHR operational usage and best standards of care. Let Point-of-Care Partners help you identify those opportunities for your accounts and translate them into action.