Northwell Health Solutions, Using Healthix to Fill Gaps in Care

Today, healthcare providers go beyond treatment, offering preventative care and routine check-ups to keep patients healthy. Through value based care (VBC) models, the provider is financially rewarded when their patients successfully achieve a core set of care metrics (e.g., breast care screening).

“The significance of Healthix information is not in the mass volume of data available, but in the meaningfulness to close specific gaps for keystone patients. Simultaneously, it provides a secondary benefit of a greater understanding of these patients and where and when they receive care, which allows us to adjust resources and strategies.”

– Kimon Stathakos, Senior Director, Operations at Northwell Health Solutions

To provide optimal care and earn financial incentives, providers spend hours engaging with and outreaching to their patients, which can be both difficult and time consuming. In New York, where patients often receive care across multiple providers, it’s hard to know if gaps in care have been met elsewhere. Healthix data provides insight into the care delivered across providers, hospital networks and geographies.

Value Based Care Drives Optimal Care and Financial Incentives

Northwell, one of the largest healthcare systems in the nation, currently uses the monthly Healthix Gaps in Care Report as an additional layer of information on top of its own data, to examine and fill patient gaps.

The Northwell Team has recently published a peer reviewed manuscript in Population Health Management for their implementation of a “Value-Based Pay-for-Performance Gaps in the Care Delivery Framework for a Large-Scale Health System” that outlines their process. The manuscript addresses patients selected by health plans who have not yet received preventative care measures and looks to connect them to providers. In particular, the focus is on 60,000 patients with over 100,000 care measures.

The VBC team used the Healthix reports from January until September in 2021 so far and matched gaps of 11,766, of which Northwell was able to recognize compliance and accept 3,785 gaps, 30% success rate.

So what does that mean?

Knowing a patient is compliant with their care measures saves significant staff time in patient outreach and/or chart reviews/abstractions, (average 5 min. per patient across approximately 2,500 patients = 200+ hours saved conservatively).

• Complete care measures based on Healthix data allows the VBC team to submit the Healthix sourced information to payers as supplemental data. This has resulted in a one STAR increase across at least 3 payers so far which allows them to achieve key performance incentives/earnings.
• The Northwell VBC group found Healthix data especially valuable in identifying colorectal cancer screenings, and to a lesser extent, breast cancer screening. While many care measures related to blood pressure and diabetes care, such as HbA1c control were provided by Healthix, benefit analysis is still ongoing due to time sensitivity of the data.

“The Healthix Gaps In Care report is high quality and well curated. It is provided for only consented patients. While this will not end all your data acquisition needs, it has proven very cost effective and well worth the investment. To be truly effective, a process of how your organization will use and act on the data is necessary — which I believe any large or even moderate sized organization involved in value based care will have in place.” K.S.