Umpqua Health, a leading healthcare organization in the Pacific Northwest, faced significant challenges in achieving their value-based care (VBC) objectives, improving patient outcomes, and managing costs. To tackle these issues, they partnered with Rely Health, a company renowned for its scalable care navigation programs powered by AI technology. This case study explores how the collaboration between Rely Health and Umpqua Health resulted in substantial improvements in closing care gaps, enhancing patient engagement, and boosting overall value-based care performance.
Umpqua Health serves communities across the Pacific Northwest. With the healthcare landscape shifting towards value-based care models, Umpqua Health recognized the necessity of enhancing patient engagement strategies, effectively closing care gaps, and reducing total care costs while improving outcomes.
Rely Health provides an innovative solution that merges AI technology with human patient care navigators to develop scalable care navigation programs. Their platform helps healthcare organizations identify and address care gaps, engage patients more effectively, and streamline care processes.
Through collaborative discovery, several challenges were identified that hindered Umpqua Health from meeting specific VBC goals, particularly related to two quality measures within the Emergency Department (ED).
Rely Health initiated their partnership with a comprehensive systems assessment at the hospital. This assessment uncovered significant limitations in patient outreach capabilities, stemming from excessive administrative burdens, repetitive processes, and the manual documentation demands placed on the existing team.
These inefficiencies led to low engagement rates and poor visibility into VBC metrics. Moreover, scaling was a considerable challenge. Due to labor constraints, hospital EDs struggled to identify patients with care gaps across their population in real-time. Additionally, they lacked the capacity to ensure patient compliance with prescribed care plans. Recognizing these hurdles, Umpqua Health aimed to address them by partnering with Rely Health to design a Discharge Navigation Hub.
To address these challenges, Umpqua Health partnered with Rely Health to implement a comprehensive Value-Based Care Navigation Program. This innovative hub was intended to deliver high-quality concierge care, effectively addressing these populations and driving success in their value-based care initiatives.
The implementation of Rely Health's program at Umpqua Health followed a strategic approach:
Several factors contributed to the success of the partnership between Rely and Umpqua Health:
Within 120 days of partnering with Rely Health, Umpqua Health achieved significant improvements and met or exceeded their performance metrics for the end of the year.
The partnership between Rely Health and Umpqua Health demonstrates the potential of AI-powered care navigation programs in driving value-based care success. By leveraging a Navigation Hub designed by Rely Health, Umpqua Health was able to significantly improve care gap closure, patient engagement, and overall healthcare delivery efficiency. Within 120 days, the collaboration led to remarkable outcomes, including high appointment adherence, improved patient retention, and increased connections to primary care providers. The seamless integration of Rely Health's AI-powered platform with Umpqua Health's existing systems facilitated the identification and closure of care gaps, personalized patient interactions, and efficient scaling of patient outreach efforts. This approach not only addressed immediate challenges but also laid a robust foundation for ongoing value-based care initiatives.
As the healthcare industry continues to evolve towards value-based models, partnerships like this one between Rely Health and Umpqua Health may serve as a blueprint for other organizations looking to enhance their VBC performance and improve patient outcomes. By focusing on hyper-personalized outreach, multi-channel engagement, and addressing social determinants of health, Umpqua Health demonstrated how strategic partnerships and advanced technology solutions can significantly enhance the quality of care delivered to their communities while effectively managing costs.
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