ZirMed Offers What's Needed to Succeed in the Value-based World
ZirMed began with a simple mission: Providing an effective and efficient tool that would enable healthcare organizations to maximize reimbursement. As the industry moves toward value-based reimbursement – where healthcare organizations are reimbursed based on quality of care, not simply the quantity of care – ZirMed is still carrying out its mission, but in a decidedly different manner.
Here, Frank Bordonaro, vice president of health analytics, explains just how ZirMed is uniquely positioned to support today's pay-for-performance programs by:
#1 Providing the Complete Patient Story. ZirMed processes claims for healthcare organizations across the continuum including hospitals, outpatient facilities, surgery centers, home health, skilled nursing facilities – and many others. With access to this massive volume of claims data, ZirMed can pull together a complete picture of each patient's healthcare journey. Such a view is becoming exceedingly important as the population ages, and many patients suffer from multiple chronic conditions. "Getting a full view of the care that patients are receiving is more important than ever before. To get this information from clinical data is very difficult. Claims data is the most accurate, prevalent and stable source of this information. With ZirMed's footprint that extends across the continuum, we are providing the broad and in-depth visibility into care that is needed," Bordonaro says.
#2 Coordinating care through effective cross-continuum communications. ZirMed also provides a communications platform that enables caregivers across the continuum to seamlessly communicate. "We are leveraging our broad footprint to enable clinical communications among all caregivers, from hospital to outpatient or primary care to specialty care," Bordonaro says. Such communication helps avoid unnecessary gaps in care. For example, if a patient is referred to a primary care doctor when discharged from the hospital, all parties are aware of the needed care to avoid a costly readmission to the hospital.
#3 Empowering patients to make informed care decisions. By drawing upon comprehensive data, ZirMed gives providers the comprehensive clinical and financial information needed for patients to make informed decisions about their care. "Organizations are able to give patients the full information needed for them to make an informed decision about their care. Patients often don't follow through with treatment or keep appointments because they are not sure of their financial obligations," Bordonaro says. "It's amazing because when we bring our car to the mechanic we always expect an estimate. In healthcare, we don't demand the estimate. What happens, though, is that lack of information serves as a deterrent to getting needed services."
#4 Enabling organizations to achieve the triple aim. With the recent acquisition of Intelligent Healthcare, a population health management company, ZirMed is now enabling healthcare organizations to apply the sophisticated analytics that will enable them to achieve enhanced clinical care, improved population health and lower costs. Intelligent Healthcare's solution aggregates clinical and financial data from a variety of disparate healthcare information systems to deliver real-time quality tracking, gaps in care and population health management solutions for value-based reimbursement programs. The solution supports provider organizations as they work to meet and exceed goals for public and private P4P, Medicare Shared Savings Programs, Commercial Accountable Care Organizations (ACOs), PQRS/HEDIS scores, Patient Centered Medical Home (PCMH) models, and other value-based care programs.
"With Intelligent Healthcare, we are now able to provide the comparative analysis that healthcare organizations can use to benchmark their services. For example, one cardiology provider might be providing treadmill therapy while another does not. The information garnered from the analytics will be used for CMIOs and other clinical staff members to start discussions on the value of providing the treatment option," Bordonaro says. "This is how organizations will start to deliver the best care possible at reasonable costs."