Hi Hospitalogists! Blake here.
Today, we’re continuing the series on all things care navigation in partnership with Care Continuity (Read Part 1 here!).
For Part 2, I’m diving into Care Continuity’s distinct differentiation as one of the most experienced navigation platforms working with health systems, payors, and risk-bearing organizations – and how their team is leveraging 10+ years of accumulated navigation data to drive outsized ROI for their customers.
In working with the Care Continuity team and with their HQ being in Dallas, I personally think their service is worth a conversation at minimum!
Let’s dive in.
This essay is a sponsored post in partnership with Care Continuity. I write these posts for companies with offerings or missions I believe can provide value-adds for Hospitalogy subscribers, many of whom work with/for hospitals or provider organizations that deal with issues like care navigation, length of stay management, network integrity. and patient leakage on a daily basis.
If you’re interested in a sponsored deep dive, please reach out to [email protected]!
The Care Continuity Difference. Key Takeaways:
Health systems and health plans have invested significant resources building comprehensive, high quality care delivery networks.
But provider networks are complex. It’s hard to understand where gaps or inefficiencies might exist within them.
Care Continuity solves complicated problems within provider networks and care transitions related to issues like network leakage, underutilized resources, poor outcomes, patient stress, higher costs, increased readmission rates and ultimately, lost market share and unmanaged risk.
The Care Continuity team has operated in the care navigation space for 10+ years. Over this time horizon, they’ve collected data from 2 million longitudinal patient journeys and now power 100+ hospitals, ACOs, and health plans.
As a result, their team holds a significant edge in training machine learning models and developing advanced analytics to create smarter navigation and care coordination pathways. Think of Care Continuity as the advanced air traffic control center for your health system (and yes, much better than Southwest’s)
Smarter navigation and coordination products lead to outsized ROI for Care Continuity clients – e.g., health systems and ACOs – with navigation results 3.5x better than baseline navigation efforts on average.
If you haven’t gotten serious about investing in your care coordination strategy, it’s worth a conversation. Get in touch with the Care Continuity team here!
Care Continuity: Transforming Patient Navigation
Imagine a world where every patient seamlessly transitions from one care setting to another, never worrying about missing a follow-up appointment or getting lost in the shuffle. This is the vision Care Continuity wants to bring to healthcare with their team’s advanced patient navigation solutions.
We’ve all heard of care navigation or coordination, but how is Care Continuity different? Diving into their specific value props, here’s where the Care Continuity platform shines and the specific problems solved with clients to-date:
- Maximizing Investments: Health systems and health plans invest heavily in building comprehensive, high-quality care delivery networks. But unfortunately, these investments often don’t reach their full potential due to reliance on patient self-navigation or ad hoc tools. Sounds about par for the course for healthcare (yeah, you know I had to throw a golf reference in).
- Eliminating Inefficiencies: Poorly managed transitions lead to network outmigration (leakage), underutilized resources, poor outcomes, patient stress, higher costs, increased readmission rates, lost market share, and unmanaged risk. Care Continuity eliminates these inefficiencies.
- Leveraging Experience: With over 10 years of in-market experience, Care Continuity powers high-value, non-clinical patient navigation programs that significantly enhance patient care and operational efficiency.
- Proven ROI: Care Continuity’s platform and services are trusted by over 100 hospitals, ACOs, and health plans across the U.S., generating an impressive ROI of 4x to 5x+ on average.
- Downstream Specialist Referral Coordination: Managing specialist referrals and making sure patients stay within aligned specialist networks is a pain point for many health systems. These referrals, often coming from entry/acquisition points like emergency departments or primary care visits, are crucial to capture for health systems. As we know, specialty visits lead to downstream higher dollar procedures that significantly contribute to the organization’s bottom line. But on the patient side of the equation, the patient most in need doesn’t always get seen first. Compounding the problem, existing processes and technologies often fall short, leading to a mismatch between the demand for specialty care and the availability of specialists.
- Care Continuity tackles this challenge head-on by transforming how hospitals navigate patients through the provider network. Using machine learning, they prioritize patients for navigation and map out optimal care journeys. With over a decade of experience and having navigated more than two million patients, Care Continuity has amassed a wealth of data. This data allows them to pinpoint which patients need navigational support, who is most likely to accept it, and the best ways to engage them—whether face-to-face, digitally, or a combination of both.
Care Continuity’s Navigator Predict Module: Advanced, Flexible Analytics
Going deeper into the data side of things, Care Continuity’s advanced analytics give clear insights into patient movement in the network. They show where delays happen and where patients get lost due to logistical issues or long waits. These insights help health systems fix problems, plan for improvements, and improve patient outcomes and efficiency.
Here’s a quick snapshot of the AI-enabled Navigator Predict Module they’ve developed, which delivers predictive patient analytics across multiple dimensions:
Navigator Predict is a key piece of technology now core to Care Continuity’s offering, and where care navigation is headed in general. The machine learning technology captures demographic and clinical information, along with follow-up care instructions, through a real-time interface with the EMR.
Here’s how it works: after a triggering event, like an ED visit or a referral from a primary care provider, longitudinal patient journey information is combined with over 50 weighted navigation variables proprietary to Care Continuity. Then, a multi-factorial prediction score is calculated for each patient, indicating the likelihood of successful navigation. It acts as a mini-triage system, delivering higher need patients where they need to go, faster.
I’ve alluded to an air traffic control system, but you can also think of the platform as an Uber-like demand matching interface for patients. For these patient scores, higher scores mean patients most in need of navigation are prioritized and vice-versa, ensuring patients go where they need to more quickly, leading to increased efficiency within the health system.
It’s also a two-pronged effect: identified higher score patients are likely to have higher acuity needs, leading to more patient volumes for specialists and proceduralists and a boost to case mix index. The patient also gets seen in a timely manner, leading to better outcomes.
Care Continuity’s ROI for Health Systems and ACOs
What does all of this translate into?
Here’s a handy graph that exemplifies the ROI of using Care Continuity’s interface over typical navigation solutions.
For health systems trying to perform navigation services on their own, it can be inefficient and cumbersome to find patients who are both in need of navigational assistance and are willing to accept the service.
Care Continuity brings drastic efficiency to this identification process for its clients, increasing navigation results by 2.6x to 3.5x over baseline efforts. Their solution is ~3 times more efficient than what a typical health system, ACO, or health plan could do with its own in-house resources.
Simply put, Care Continuity has the data and expertise.
To get a bit more granular, here’s an annotated graph I put together spelling out exactly what’s going on when Care Continuity works with a client like a health system.
By applying its machine learning models to the given patient population from a customer, Care Continuity accurately predicts 60% of the patients who are likely to say “yes” to navigation services (”Yes patients”), while only navigating roughly 20% of the total patient population. This “yes” patient segment is what the green box in the graph above represents.
With Navigator Predict, health systems drive significant efficiency gains over their competitors. Traditional methods would require navigating 3.5 times more patients to match the outcomes achieved by Care Continuity’s technology, matching the right patients with the right care setting in an Uber-like fashion. The Care Continuity process translates to significant cost savings, improved patient outcomes, and better resource utilization.
The Care Continuity Difference and why you should learn more about their offering
To bring it all together, health systems and ACOs working with Care Continuity can supercharge their navigation services across multiple dimensions. Some examples of success stories:
- Reduced length of stay and easier care transitions
- Reduced readmissions
- Increased patient retention with network-aligned providers (less leakage)
- Higher quality care and less frustration from providers
- More satisfied patients
- Better utilization management
It goes without saying, but while some of the above are qualitative elements, many of Care Continuity’s value props directly tie to increases in revenue through more patient volumes or better quality metrics.
Care Continuity’s innovative patient navigation solutions offer a transformative approach for health systems and risk-bearing organizations aiming to improve patient outcomes and satisfaction with a complex system, enhance operational efficiency, and boost margins.
By addressing the complexities of specialist referrals and leveraging the power of machine learning and analytics, Care Continuity ensures seamless transitions, better resource utilization, and superior health outcomes. It’s not just about navigating patients; it’s about steering healthcare towards a brighter, more efficient future.
If you want to learn more or have any questions, Get in touch with the Care Continuity team here!
