mHealth in the Time of MACRA

mHealth Application Applying MACRAIn a recent PwC report on the top healthcare issues for 2017, unsurprisingly, the impact of MACRA on value-based payment models made the list. Many provider networks have taken the last several years to focus on up-side risk sharing while expanding their network reach in both size and scope. However, as providers enter the first performance year of MACRA, the push towards more widespread adoption of two-sided risk models poses new challenges to healthcare decision makers, including:

    • How to maintain patient and treatment volumes to ensure revenue
    • How to appropriately track and report on patient outcomes across the care continuum
  • How to engage with patients to promote improved outcomes

In the ACO model, transitioning care towards the primary care setting brings certain potential risks to the revenue cycle of healthcare networks and groups – of which perhaps the most important is the risk of patients going out-of-network for specialist care.

So, how can large healthcare networks and hospital systems secure patient revenue in the age of the “healthcare consumer?” This is one area where mHealth application development may provide a tangible ROI to healthcare organizations. Providing patients with a branded mobile app is a unique opportunity to acquire a valuable piece of real estate on patient devices, and keep the group’s brand top-of-mind for patients when seeking care. This ability to frame the choice of providers for patients can be very powerful in securing patient loyalty to the healthcare network, which directly translates into increased revenue and potential per patient value.  

For those organizations that choose to develop a branded mobile health app for their healthcare network or hospital system, this singular point of access can be leveraged to provide additional value to both patients and the organization itself. Mobile features like appointment scheduling, lab results, access to the patient portal, and access to health records (some of the top digital features requested by patients), as well as customized care management plans for patients with chronic conditions, can all help. They have the potential to impact revenue both by keeping patients in-network and by improving patient outcomes, allowing organizations to secure positive MACRA payment adjustments.

Are there other ways to leverage mHealth applications? There are plenty of emerging technologies that could eventually provide additional value. Many are still in very early stages in terms of evaluating effectiveness and impact, how to receive reimbursement, and how to meet regulatory challenges. These need to be explored and addressed, but the future looks bright for health systems that decide to take advantage of the ubiquitousness of mobile devices and the access they provide.

As Director of Business Development, Michael is passionate about helping healthcare systems successfully transition to value-based care.

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