How HealthLoop advances value-based care

Enabling technologies to enable patients and caregivers to work together effectively

As healthcare reform remains the hot-button topic in Washington, Silicon Valley has stayed focused on contributing in its own way: Creating technologies to drive down costs and improve outcomes. In other words, technologies that incent patients to be more proactive with their own health and technologies that collect and synthesize data to enable care providers to do their best work.  

Ultimately, this enables a payment system that rewards quality and not quantity, which is referred to as value-based care. We’re big proponents of advancing this concept, and moving away from traditional fee-based models, which is why the Vator Investment Club invested in HealthLoop, in its latest round, led by Canvas Ventures, Lafayette General Hospital, Summation Health, among others.

HealthLoop essentially works with physician groups and hospitals to enable them to interact and communicate daily with patients admitted for surgeries or hospitalizations. Through HealthLoop, physicians and care management teams can interact with the patient pre-and-post admission.   HealthLoop incorporates the tailored protocols that each physician team so the HealthLoop system enhances their work, rather than change it.

Patients can then interact with their physician via mobile phones and tablets. Patients are asked how they’re feeling, or whether they have certain pain, and or whether they’ve taken a specific medication. All this information gives the care team visibility to determine how to engage with their patients, and which ones need more attention and treatment.

The program, as Todd Johnson, CEO and co-founder, explained to me is “equal parts guidance and pro-actively asking patients how they’re feeling.”

This connection and communication between patient and physician or care management team is extremely crucial since miscommunication amongst providers and patients is a major cause in medical errors and loss of lives. It’s also a big driver of readmissions. One out of every five patients discharged from hospitals experience an adverse event, partly because the data about a patient lives in multiple places.

Hospitals can’t afford to have readmissions. Under the Hospital Readmission Reduction Program, they’re mandated to reduce readmissions, at least for Medicare recipients. They’re also incentivized to earn credits under the Merit-based Incentive Payment System. HealthLoop helps hospitals reduce readmissions by firstly measuring the quality of care by collecting the data. As Johnson puts it: “You can’t improve what you can’t measure.”

To this end, the simple fact that physicians are starting to measure their work using HealthLoop earns them points. Physicians can earn 15 percent credit towards MIPS just by simply saying they use HealthLoop. This acts as a regulatory tailwind for companies such as HealthLoop.  

And overall, this incentive is good for the entire healthcare ecosystem. The Medicare Payment Advisory Commission (MedPAC) has estimated that 12% of readmissions are potentially avoidable and that preventing even 10% of the readmissions could save Medicare $1 billion.

This is a great step toward consumers engaging and working with physicians to improve health outcomes. It takes both sides to work together, but clearly technology is helping to create that connection and achieve the goal of quality care.

Thoughts on consumers taking charge

Many argue that the fact that employers and insurance companies act as middlemen between care providers and individual is the reason people aren’t in control of their own health. In other words, they’re not consumers of healthcare, like they are for other goods and services.

Yet to some extent, people are already in control. Consider chronic conditions, such as heart disease and diabetes, which absorb a great deal of healthcare spending but are also highly correlated with our lifestyles. We already can affect our outcomes by reducing our risks of heart disease - the number one cause of death - by eating a healthy diet, exercising regularly, and staying happy and stress free.

Last I checked, no one is standing in my way: I’m free to spend my money on a wide selection of gyms, food, activities and ways to keep myself happy. To this end, people are extremely proactive in healthcare decisions already. In fact, if everyone made healthier choices, we might not have the spiraling healthcare costs we have today.

That said, we all age; we all get into unforeseen accidents; Some 35 million people will still end up in hospitals each year.

As innovators, we need to find areas where we can help improve the system. We may not be able to force people to stop eating sugar and fatty foods, though there are innovators creating new ways to encourage wellness. But we can also create technologies that enable caregivers and patients to work together more effectively. That’s what HealthLoop does and we’re excited to be a part of their journey.