Page 12 – Bamboo Health

Webinar Recording: What’s Next for E-Notifications?

Posted on December 16, 2021June 8, 2023 by Grace Keeling

The deadline to comply with the Centers for Medicare and Medicaid Services Interoperability and Patient Access Rule Electronic Event Notifications Condition of Participation was May 1, 2021. In short, the rule requires hospitals to send admission, discharge, and transfer (ADT) notifications to patients’ other healthcare providers. The intent was to promote care coordination and value-based care, but for some, the rule has meant more work and red tape, while resources are low in part due to the continuing pandemic.

Bamboo Health’s Manager of Government Affairs breaks down the current implications of the rule as well as what it could forecast for the future of healthcare interoperability. Plus, we’ll help navigate CMS’s Interpretive Guidance for the rule, particularly regarding what hospitals need to know about “reasonable effort” and “making every attempt possible” to achieve compliance.

Coordinating Behavioral Healthcare for a Healthier America

Posted on December 16, 2021October 12, 2022 by Grace Keeling

Uncoordinated behavioral healthcare has cost America money, and more importantly, lives, for far too long. Today, we’re working to fix it.

Seemingly forever, patients’ medical records have been scattered about, first in paper files on office shelves and now on servers in data centers. To get one record from here to there—and to get it in the hands of the right clinician at the right time—has been a logistical nightmare. Picture a long chain, but with a missing link.

Today, this problem translates to an array of measurable issues for all of healthcare, two of which are most crippling: high, often unnecessary costs and compromised care. These issues are a direct result of primary care physicians (PCPs), specialists, and other care team members, along with insurers, being unaware of their patients’ whereabouts on the care continuum—particularly, the behavioral care continuum—and unable to effectively manage their care.

To illustrate the magnitude of the cost issue, the Journal of the American Medical Association, or JAMA, estimates that the “total annual costs of waste were $760 billion to $935 billion” in one year. That’s nearly one trillion dollars in unnecessary care, or nearly one quarter of the total annual healthcare spend in America. This plagues patients and their insurers and hinders value-based care efforts.

As for compromised care, consider the high utilizer who repeatedly visits the emergency department (ED), or the individual with a behavioral health disorder who is admitted to a treatment facility, both without their PCP’s knowledge. This leads to less communication between their PCPs and specialists, which can result in inefficient administration of medication, procedures, and tests, a lack of timely follow-ups, and even harm.

State health departments, health information exchanges, and other entities have long worked to consolidate, secure, and share relevant patient information on a large scale. While they have certainly made progress and will continue to play a major role moving forward, they operate in a somewhat fragmented environment and don’t necessarily foster communication among providers and between payers and providers. In addition, behavioral health and crisis event data remain siloed at a time when access to such data is more important than ever amid a worsening opioid epidemic.

A recent study on healthcare coordination conducted by researchers from the Commonwealth Fund highlighted this problem. “Compared to physicians in other countries… U.S. physicians did not routinely receive timely notification or the information needed for managing ongoing care from specialists, after-hours care centers, EDs, or hospitals.” Furthermore, “Ensuring the continuity of care delivered in settings outside the four walls of a primary care practice, but with the involvement of primary care through timely information exchange, is a central prerequisite for coordination.”

This is precisely why Appriss Health + PatientPing became Bamboo Health. We combined a company defined by data and analytics and another defined by real-time information sharing for the improvement of care coordination.

“We have created one of the largest and most diverse care collaboration networks in the country, connecting nearly one million healthcare professionals in all 50 states and virtually all care settings including primary and specialty care, emergency departments, urgent cares, inpatient facilities, skilled nursing facilities, post-acute facilities, behavioral health treatment centers, pharmacies, home health agencies, state health agencies, and social and human service agencies, among others,” said Rob Cohen, Bamboo Health’s President and General Manager. “Our powerful network serves the largest hospital systems in the U.S., 45 state governments, every national pharmacy chain, 37 payers including the top eight health plans, and 7,800 post-acute facilities.”

As Rob alluded to, we’re here to coordinate behavioral healthcare by growing one network on one platform. By connecting PCPs with specialists, payers with providers, and behavioral health with physical health. By fostering communication with data, analytics, and real-time alerts. And by keeping the patient at the center. It’s coordinated care that can reduce costs and save lives.

We’re the missing link in the chain. And we’re just getting started.

How the CMS Interoperability and Patient Access Rule Creates a Vision for Interoperability and the Delivery of Whole Person Care

Posted on December 2, 2021June 9, 2023 by Grace Keeling

As of May 1, 2021, U.S. hospitals must comply with the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access Rule electronic event notifications (e-notifications) Condition of Participation (CoP) requiring hospitals to send Admission, Discharge, and Transfer (ADT) e-notifications to all requesting post-acute providers, primary care providers, and primary care entities.

The CMS e-notifications CoP is designed to help hospitals better serve their patients through improved care coordination and enhanced interoperability among providers. This is done by requiring hospitals, psychiatric hospitals, and critical access hospitals to share electronic ADT-based care e-notifications with other community-based providers and care team members, including post-acutes. This means that all hospitals utilizing an electronic health record (EHR) service provider or other electronic administrative system that is conformant with the content exchange standard HL7 v2.5.1, must make a reasonable effort to send real-time electronic notifications.

For reference, CMS states that the reasonable effort means sending the ADT e-notifications:

At: the point of inpatient and observation admission, discharge, and transfer, and at emergency department (ED) presentation and discharge;
To: the patient’s established primary care provider (PCP), established primary care practice group or entity, other practitioners, practice groups or entities identified by the patient as primarily responsible for his or her care, and applicable post-acute providers who need to receive notification for treatment, care coordination, or quality improvement purposes;
Containing: at minimum the patient’s name, treating practitioner’s name, and sending institution’s name.

While the deadline for hospitals to comply with the CMS E-Notifications CoP has passed, it does not mean a hospital’s job and mission to improve care coordination is done. Despite the rule now being in effect, many hospitals have begun to think about the road ahead and how it’s beneficial for new care approaches like whole person care. These approaches can allow healthcare providers that have integrated a CMS-compliant solution to introduce new levels of visibility into a patient’s care journey with e-notifications.

Reaching Beyond the E-Notifications CoP Toward Interoperable Whole Person Care Coordination

Over the past few years, there have been numerous changes to the interoperability and value-based care landscape. With new rules proposed and finalized, innovation models created and phased out, directional changes in the industry are favoring a focus on care coordination. With rules from ONC and CMS, and updates from CMS and the Center for Medicare and Medicaid Innovation (CMMI), the industry continues to rapidly evolve and look to support future care coordination needs.

By requiring hospitals to send real-time e-notifications at the point of inpatient admission, discharge, and transfer, and at ED presentations or discharges, CMS took a step forward to ensure that all providers will ultimately have access to timely information to further care coordination. The result is an advancement toward the growth of value-based care delivery models and increased interoperability across the care continuum, with each of the two further driving the other.

While much may change in the coming years, care coordination remains at the heart of both sides of this equation. Sharing real-time information via ADT events about patients’ care encounters across providers introduces new levels of visibility for respective care teams, driving whole person care initiatives which can reduce ED utilization, prevent hospital readmissions, avoid unnecessary procedures and tests, eliminate medication errors, treat behavioral health problems holistically, and identify and manage social determinants of health.

New technology solutions are now supporting whole person care and can ensure that hospitals achieve compliance with the CMS e-notifications CoP and deliver enhanced value-based care coordination initiatives. By enabling healthcare providers with insight into the patient care journey, they gain a new understanding of all the issues that an individual is dealing with so they can prioritize and coordinate care plans to improve health outcomes.

At Bamboo Health, our healthcare solutions are facilitating exactly that. No matter who the provider is, no matter what the care setting is, they can look at the individual as a whole person and uniquely coordinate how they are going to care for that patient. This technology, paired with our expansive national footprint, arms healthcare providers across the country with a greater view into all of the conditions that an individual is managing, creating a whole person view that powers whole person care.

To learn more, check out our ebook:

EBOOK: the route to compliance: now that we’ve arrived, what’s next?

Three Key Takeaways from HLTH 2021: Driving Change through Care Coordination to Transform Whole Person Care

Posted on October 28, 2021June 9, 2023 by Grace Keeling

Bamboo Health recently had the pleasure of exhibiting at HLTH 2021, which served as the first opportunity to unveil our new company brand in person since launching in late August. HLTH also provided a great chance for our team to participate in important discussions with an esteemed group of healthcare leaders, government officials, policy experts, politicians, and tech influencers. Below is a summary of the three key takeaways from our discussions that will help to shape the healthcare industry’s future.

1. Care is Moving Beyond Hospital Walls

According to the U.S. Census Bureau, older adults are expected to outnumber children in population size by 2034, with 65-year-olds and over projected to number 77 million, which comes as no surprise as the Baby Boomer generation continues to age. As a result, the home healthcare industry represents one of the fastest expanding industries in all of healthcare. The Home Care Benchmarking Study by Home Care Pulse projects that in 2021, there will be approximately 9,000 more home care agencies than there were five years ago. This follows 2020, a year in which U.S. home care spending reached an all-time high of $113.5 billion.

COVID-19 has accelerated this trend, making it more acceptable for people to seek accessible and affordable care options. Beyond home healthcare providers, points of access now include retail clinics, behavioral health clinics, and community centers. As the population continues to age and patients increasingly choose to remain in their homes, the boundaries of clinical capacity will continue to extend beyond traditional physical and geographic lines.

2. Consumerization of Healthcare

Adding to the growth of home healthcare, it’s never been clearer that how we access healthcare is changing. In the past, when we got sick, we all traveled a similar patient journey utilizing primary care providers or hospitals; however, that paradigm has shifted. Patients increasingly prefer to receive convenient care via today’s technologies.

From telehealth options to at-home testing kits to remote monitoring systems to primary care in retail pharmacies, these developments, along with increased public openness to receiving new methods of care, have forced providers to partner with tech companies on solutions. This shift in how we access care has the potential to enable a more personalized, cost-effective, value-based care delivery model.

3. Value-Based Care is Here to Stay

While there have been numerous changes to the value-based care landscape over the last few years, the acceleration toward value-based care models is still hot. This is partly due to the emphasis that federal and private payers have placed on increasing access to care and lowering total cost of care. And this underscores the importance of products and services that put the patient’s whole care experience first. Through effective care collaboration about patients’ care encounters across the physical and behavioral health spectrums, care teams gain new levels of visibility to improve care quality, reduce total cost of care, and minimize post-acute spending and unnecessary emergency department visits.

Bamboo Health solutions enable just that by supporting one, connected network—all with care coordination and total cost of care top of mind. For example, we recently announced that Bamboo Health’s national network of Accountable Care Organizations (ACOs) generated over $1 billion in total shared savings in 2020 under the Medicare Shared Savings Program (MSSP). Bamboo Health’s ACO partners achieved this success in the value-based care program by utilizing our Pings solution, which provides real-time visibility into patient admission, discharge, and transfer (ADT) care events. Pings enables ACOs to identify high-utilizers, monitor post-acute length-of-stay, and apply timely interventions to reduce emergency department to inpatient conversions.

The Future of Healthcare

In closing, we are encouraged by the positive input and feedback that we received at HLTH. The event provided a refreshing reminder that innovation in the healthcare industry—and transformational change—is well on its way.

At Bamboo Health, we believe the key to better care rests in ensuring that all participants in the care continuum have access to real-time patient data and the ability to coordinate and collaborate with other providers. Whether patients are at home or utilizing the latest technologies to meet their needs, real-time information provides clinical intelligence to successfully prioritize and deploy services and ensure seamless care transitions, while also creating optimal opportunities to deliver on the promise of value-based care.

We look forward to leveraging this positive momentum as we continue our work creating one of the most comprehensive, diverse care collaboration networks in the country.

Webinar: The Power of Pings: How a Statewide Mental Health Provider Tracks and Manages its Patient Population

Posted on October 15, 2021June 9, 2023 by Grace Keeling

Recently, we presented a webinar: The Power of Pings: How a Statewide Mental Health and Human Services Provider Tracks and Manages its Patient Population with Real-Time Notifications. The webinar was a joint effort between Bamboo Health and our customer, Monarch. Since 1958, Monarch has provided the state of North Carolina with comprehensive specialty mental health and human services; Today, they serve 28,000 patients. They pride themselves on providing a nurturing environment for people with intellectual and development disabilities, mental illness, and substance use disorders. You can learn more about Monarch, here.

Over the past few years, Monarch experienced a growing challenge: the ability to efficiently track and effectively manage their patient population. With Monarch’s growth came a more diverse patient population, based on geographic area, medical history, type of insurance, and more. Additionally, the Substance Abuse and Mental Health Services Administration Center for Mental Health Services awarded Monarch a Certified Community Behavioral Health Clinics Expansion Grant. While the grant provided opportunity, it also set strict regulations related to patient care coordination.

To answer this challenge, Monarch partnered with Bamboo Health to implement Pings, which delivers real-time notifications to care team members when their patients experience care events across the continuum. Pings helped Monarch become more informed on both a broad scale and provider-level scale.

Monique Lucas, vice president of integrated care at Monarch, had this to say, “After about a year with Pings, we realized the value that it brought. We were able to utilize the data to build dashboards that gave us a clearer picture of what we were dealing with and how to handle our hospitalization population.”

To hear much more from Monique about how Pings revamped Monarch’s healthcare coordination efforts, check out our webinar recording.

Public Health Playbook: Planning for a Behavioral Health Crisis Response Solution

Posted on October 6, 2021June 9, 2023 by Grace Keeling

The following is an excerpt from our playbook. To read the full playbook, click here.

The need for coordinated services to help individuals in the midst of a behavioral health crisis is immense. One in four Americans has a mental health or substance abuse disorder, yet fewer than half of adults (45%) with mental health illness receive care each year and the percent of individuals reporting an unmet mental healthcare need rose to 11.7% in early 2021. Meanwhile, suicide is the tenth leading cause of death in the U.S., claiming the lives of more than 44,800 people in 2020 alone.

Whether at the city, county, or state level, the ability to better support crisis management is critical for our communities to connect anyone, anywhere, to the right care anytime. Support for such services is increasing. The federal government plans to launch 988 as the national suicide prevention and mental health crisis hotline in July 2022, and is increasing funding for crisis services—including community-based mobile crisis teams, hotlines, equipment, and training.

Having an effective behavioral health crisis response solution is an essential component for coordinating services. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), these systems operate as air traffic control for crisis management services, and should include:

A GPS-enabled mobile team dispatch
Real-time bed registry and coordination
Centralized outpatient appointment scheduling
Performance dashboards to support coordination

Knowing where to begin in developing such a solution, however, can be daunting. To help, Appriss Health has assembled initial steps and key considerations from our years of experience working with states and thought leaders to develop crisis management technology.

ASSESS YOUR CURRENT PROCESSES AND IDENTIFY GAPS

To understand where you need to go, you first need to understand where you are. This step begins with taking an inventory of existing technology, resources, and processes, and evaluating your current care coordination system for crisis response. You should develop a thorough understanding of how local healthcare providers, hospitals, law enforcement agencies, and other entities handle behavioral health crisis cases—including if and how those individuals are referred to care and any follow-up procedures. Ask these questions:

What technology is in place?
What technology should stay and what should go, based on resources and needs?
What systems should be connected to establish an optimal crisis response solution? (CRM, phone center, phone technology, data warehouse, reporting system)

This assessment will allow you to identify what is working well today, and where there are gaps and opportunities for improvement.

DEFINE YOUR OBJECTIVES

Describe your overall public health goals, including the issues a well-designed crisis management solution should solve, the need for the solution in your community (or communities), and the key gaps you will need to fill to achieve those goals. For example, there may be gaps in the current approach to crisis care coordination, the public may lack access to—and coordination with—care resources, or communicating with and dispatching trained emergency service teams may not be part of a technology-enabled process.

To define your goals, you should understand what a successful crisis management system looks like. Download our playbook to learn what SAMHSA considers a successful crisis management system.

Blazing New Trails at HLTH: Bamboo Health Cultivates Care Collaboration to Transform Whole Person Care

Posted on October 4, 2021June 8, 2023 by Grace Keeling

The Bamboo Health team is looking forward to participating in HLTH 2021, which will once again convene an esteemed group of healthcare leaders, government officials, policy experts, politicians, and tech influencers. The event promises to foster a flurry of discussion and insights that will help shape the healthcare industry’s future.

At Bamboo Health, we believe that future focuses on the importance of cultivating care collaboration, everywhere. We’re combining patient data, analytics, and communication like never before to revolutionize healthcare across the country by connecting every payer, provider, and care team member to address whole person care.

To establish this vision, we looked to nature for inspiration. As a symbol of strength, flexibility, and health, bamboo captures the essence of everything we aspire to be. Bamboo’s qualities of resilience, ability to grow quickly, and versatility also describe our company’s ability to adapt and expand quickly to support a rapidly evolving healthcare landscape.

We connect 37 payers and one million clinicians across 50 states, creating one of the most interoperable care coordination networks in the nation. Our solutions and technology platform enable customers to optimize value-based outcomes by delivering information, actionable insights, and support for the delivery of whole person care through payer and provider collaboration. This effort blazes new trails and cultivates care collaboration—giving everyone the opportunity to thrive.

From health systems to pharmacies to state governments and post-acute facilities, we help customers across the healthcare continuum, and those in their care, gain an advantage from greater efficiencies, reduced costs, and improved outcomes by:

Connecting the disconnected, filling data gaps and fostering communication for providers and payers.
Enabling actions that reduce costs and improve outcomes through true interoperability across one of the nation’s largest care collaboration networks.
Informing the uninformed to equip providers with a more complete patient picture and enable better whole person care.

To date, our extensive infrastructure and network support the exchange of applications, information, and actionable insights in more than one billion patient encounters per year across more than 7,800 post-acute facilities, 25,000 pharmacies, 45 state governments, 2,500 hospitals, and 37 payers.

To learn more about Bamboo Health and how we are arming providers with a full view of their patient’s physical and behavioral health to cultivate care collaboration and transform whole person care delivery, visit us at HLTH. We invite you to meet and discuss Bamboo Health’s vision with our leaders, Rob Cohen, president, and Dr. Nishi Rawat, chief medical officer, during the event at booth #1133.

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