How hospitals can benefit from integrating employer health data
By Chuck Steinmetz, Chief Information Officer, Aegis Health Group
A hospital can benefit enormously from integrating health data collected by area employers and population health companies into its EHR – but far too few hospitals are doing that.
Technically, it’s not that difficult to achieve, regardless of whether a hospital is using EPIC, Cerner or any other vendor’s EHR. It really boils down to the hospital’s ability to manage the cost and priorities of overburdened integration teams, even for a project that’s quite manageable. The relatively small cost of integrating this data is nonetheless an expense – and many hospitals have limited IT staff and budgets.
But here’s the opportunity they’re missing: a chance to import vast amount of data on community members who aren’t currently using their services but could be. There are employees at ABC Corporation who have had employer-sponsored health screenings for years, but that data seldom finds its way into the local hospital’s EHR.
By comparing hospital data with this wealth of employer-gathered data, the hospital can better identify at-risk community members and help them get the upstream care they need to avoid costly chronic conditions. Guided by this data, the hospital’s affiliated physicians can be informed and prepared when those people walk through their doors seeking answers to complex healthcare conditions.
Strong alliances between the hospital and local employers also produce these major benefits:
Re-establishing primary care as the gateway to the healthcare system – According to recent data from the Centers for Disease Control, only about 54 percent of physician office visits are for primary care. U.S. census data reveals that nearly 40
percent of young people don’t visit a physician even once annually. A majority of Americans don’t have a designated primary care physician that they loyally visit, so much of their medical data is scattered across urgent care clinics and retail operations such as Walgreens clinics.
Greater revenue – When employers design wellness incentives based on a workforce health profile, employees have powerful financial reasons (e.g., cash bonuses, lower premium costs, earning points toward prizes, etc.) to establish a PCP relationship, to get regular health screenings, and to begin managing their own health. And that drives new revenue for partnering hospitals and their physicians.
Improving payer mix – Employer engagement can bring many new commercially covered lives into the health system – the working-age people with health plans that reimburse at a higher rate than Medicare/Medicaid.
Reducing outmigration – Employees who are financially motivated to see local physicians are far less likely to drive an hour to see a doctor in a larger city or to visit a brand-name healthcare provider.
Reducing payer control of health premium prices – Although some payers offer nominal population health programs, that’s a bit like asking the fox to guard the hen house. A hospital-sponsored population health strategy provides the trending and analytics to keep payers from making undue cost increases. The participating employees also tend to trust hospitals and physicians much more than they do payers.
Setting the stage for Provider Sponsored Health Plans (PSHPs) – In Utah and Wisconsin, more than one-third of consumers are already covered by hospital-sponsored health plans, which keeps more revenue in the system instead of sending a big chunk to commercial payers. Many hospitals are choosing to pilot their PSHPs by first covering their own employees, then using the lessons learned to reduce costs for area employers who want to participate.
A hospital/employer alliance is both a population health management initiative and a business development/cost reduction program. Its success depends in large measure on having a dynamic “point person” to manage the program. Many hospitals balk at this because resources are stretched thin. That’s why some population health companies are now paying for the training and salary of Employer Relations Specialists whose #1 job is to build stronger ties between a hospital’s physicians and local employers.
It’s not enough for a population health engagement tool to provide a mountain of shareable data. There’s also a human aspect critical to success. Software doesn’t develop community relationships – people do. And the people who need to take small but
significant steps (a/k/a employees) must actually do something to improve their overall health: find a PCP, get a regular colonoscopy or mammogram, take part in a stair-climbing contest, etc. There’s no amount of analytics that can replace employee engagement.
The benefits outlined above will remain out of reach until the hospital, local employers and their population health partners take the all-important first step: integrating the incredibly valuable data that lies on both the hospital and employer end.