Health plans use PatientPing services to advance pop health

PatientPing is partnering with health plans, health systems, trade associations and health information exchanges to coordinate care in real-time.

The company— a Boston-based care coordination platform founded by a former innovator at the Centers for Medicare and Medicaid Services—also is working to improve outcomes and bring the cost of care down.

So far, PatientPing is working with 15 health plans, including NextLevel Health Partners and Humana, but other PatientPing health plan clients are hesitant to share their relationships publicly.

Jay Bhimani, growth lead of payer solutions at PatientPing, says one of the biggest challenges to managing population health is knowing where patients are in real time. “Medicare data downstream is the furthest thing from real time,” he says, noting that it’s sometimes as much as three months old. Yet, real time information is critical for preventing readmissions.

Medicaid claims can take from 120 to 180 days, depending on the state, and this makes it very difficult for health plans to identify which patients are at risk of readmission, Bhimani says. Sometimes frequent visits to the emergency department might indicate other problems, such as social or behavioral issues that a health plan typically wouldn’t learn about until claims are filed.

In a six-month case study while using PatientPing, Michigan-based managed care organization Trusted Health Plan (formerly Harbor Health Plan) reported it experienced a 40 percent reduction in emergency department visits among its “super-utilizing” members, or those who went to the ED more than twice a week. The plan was also able to flag 15 of its ED “super utilizers” and connect seven of them with appropriate medical or behavioral health services to bring down cost of care. Before PatientPing, the health plan used spreadsheets to relay data that was often 90 days old.

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Another challenge to effective population health management is the fact that, even if providers know where patients are in real-time, the patient’s various providers aren’t talking to one another, resulting in fragmented care, Bhimani says.

PatientPing solves this by providing real-time notifications to providers, health systems and health plans using the admission, discharge and transfer feed, which connects hospitals to the PatientPing platform.

PatientPing can break down silos of care in an electronic medical record, enabling all the providers for a patient to have access to the patient’s movement through “bidirectional data sharing,” he says.

How the arrangement works is PatientPing provides ADT data uploads free of charge to participating hospitals, Bhimani says. The more providers on the network, the more likely a provider is of being “pinged” as to the whereabouts of a patient. Currently PatientPing has “tens of thousands of providers” participating on the platform from across the country, including 1,000 hospitals and more than 4,500 post-acute facilities—and that’s “growing daily,” he says. More than 200 accountable care organizations (ACOs) are also using PatientPing.

PatientPing is also working with trade groups and has partnerships with several hospital associations, including the Arizona Hospital and Healthcare Association, Connecticut Hospital Association and the North Carolina Health and Hospital Association. The Nebraska Hospital Association joined that list on June 26. Through these partnerships, PatientPing provides real-time notifications to healthcare providers and critical patient insights to the associations.

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