ReferWell Blog | The Loop

Why do Care Transitions Matter?

Written by Jackie Simon | Aug 13, 2020 7:15:00 PM

Our health care system today is fragmented. Providers belong to practices, clinics, hospitals, health plans and other provider networks like Accountable Care Organizations or Clinically Integrated Networks.

Providers wish they could communicate more easily within and across these various networks to coordinate care for their patients. The problem is there is no tool that integrates these providers so they can manage care transitions efficiently. So what happens when providers have limited visibility across these networks?

When providers lack an integrated care coordination solution, the onus of appointment scheduling and care coordination falls on the patient. As a result, today only 50% of recommended care transitions result in a visit and as many as 10% of patients leak out-of-network. And referring doctors only receive consult notes back a third of the time.

This costs the industry up to $150 billion per year in unnecessary spend as patients get sicker and end up in the hospital or ER for a costly visit that was avoidable.

How to Improve Care Transitions

ReferWell creates Virtually Integrated Networks, driving efficient care transitions through the last mile. Our software makes it easy for patient appointments to be scheduled at the point of care and we work directly with providers to share clinical data and close the loop, regardless of the EMR system that they use.

Virtually-integrating your care network unlocks a number of benefits:

  1. Virtually Integrated Networks (VINs) increase revenue by ensuring patients stay in-network and keep their preventive care and specialist visits;

  2. VINs reduce total cost of care and improves outcomes by ensuring that care transitions are directed to the most appropriate, lowest-cost, highest-quality providers;

  3. VINs increase revenue by getting more members assessed and coded appropriately for their risk levels and scheduling appropriate follow-up care

  4. VINs reduce ER visits, and the high cost they represent, by directing patients into a care plan managed by their PCP or specialist;

  5. VINs enable provider networks to influence patient movement by providing real-time visibility into network patterns and outcomes;

  6. VINs give patients a satisfying experience and superior health outcomes by taking the onus off of the patient to find the right provider for their care journey.

With Virtually Integrated Networks, you’ll direct patients toward the highest-quality providers, increase referral show rates, reduce patient leakage and close more care gaps — making VINs a better way to create effective care networks and drive efficient care transitions through the last mile.