Effective care coordination is a critical pillar of value-based care. And as more healthcare payers adopt value-based care models, optimizing care coordination and collaboration for diverse populations will be key. This is especially true for Medicare and Medicaid populations which can have a higher percentage of members with chronic and complex conditions (and those get costly fast).
Care coordination should improve healthcare outcomes by breaking down silos among providers, reducing costs by minimizing avoidable events, and make navigating the healthcare system easier for all via shared patient views and transparent communications.
Coordinate Effectively Across Diverse Settings of Care
HELIOS offers a broad range of benefits for care coordination and collaboration, including the ability to handle larger caseloads with limited staff resources and to automate care coordination across different care settings. Below are just some of the highlighted advantages payers can achieve related to care coordination.
Improve medication management
HELIOS offers a comprehensive capability to care coordinators for performing medication reconciliation, checking for medication accuracy, and confirming medication adherence. This capability is complemented by seamless integrations with leading embedded drug data systems, pharmacy networks, and medication therapy management solutions.
Assess more effectively and efficiently
Automated case assignment and tasking helps organize initial outreach and first-level assessment, which may include recording clinical diagnoses, reviewing medications, identifying risks, capturing social determinants of health, and evaluating community resource needs. In turn, the responses captured in the first-level assessment will automatically drive subsequent workflows.
Better coordinate ADT events
Admissions, discharges and transfers (ADT) are key events in an individual’s healthcare journey. Appropriate and timely care coordination at these moments profoundly impacts costs and outcomes. HELIOS® supports optimal care by detecting ADT events in real-time, instantly creating referrals and tasks, and providing a complete toolkit for outreach, coordination, and follow-up.
Engage and educate members and caregivers
HELIOS provides a multi-faceted suite of tools to support engaging and educating both participants and caregivers. The ability to incorporate media directly on the platform is augmented by partnerships with leading educational content providers. In addition, HELIOS’ native telehealth capabilities and mobile applications can enable organizations to drive member engagement higher.
Optimize communications and transitions of care
Care coordinators can easily communicate with multidisciplinary teams across care settings through secure, HIPAA-compliant messaging, videoconferencing, chat, and data exchange. All contacts are documented via integrated interaction forms that automatically capture many aspects of the contact.
HELIOS also plays a key role in helping care teams reduce avoidable hospital admissions and unnecessary emergency department visits. When individuals are preparing to transition or have just completed transitioning to new settings of care, team members can leverage the platform to perform all necessary coordination activities, from planning to outreach to pre-discharge assessment to education to post-discharge care planning.