Value-based care (VBC) is a healthcare model aimed at improving patient outcomes while simultaneously reducing overall healthcare costs. However, despite its potential benefits, many healthcare organisations struggle to meet the quality and financial metrics required under VBC contracts. Contact centres, traditionally viewed as cost centres, are now evolving into strategic assets capable of significantly contributing to the success of VBC initiatives. By integrating artificial intelligence (AI) and data systems, contact centres can support healthcare providers in achieving their VBC objectives while improving patient care quality.
Bridging Data Gaps for Better Care Management
Data gaps present a significant barrier to effective VBC implementation, as many providers find it challenging to access the right information when it matters most. Electronic health records (EHRs) were introduced to assist in identifying care gaps, yet much of the data collected remains underutilised. Contact centres, when properly integrated with EHR systems, can transform this dynamic by surfacing actionable insights during patient interactions, helping close these critical data gaps.
Rather than limiting their role to administrative tasks like appointment scheduling or billing inquiries, modern contact centres can identify preventive care needs and guide patients towards better health management. For instance, a patient calling about a copay payment could be reminded of an overdue cancer screening, actively closing care gaps while promoting proactive health management. Leveraging these data-driven touchpoints transforms routine interactions into opportunities for improving health outcomes and aligning with VBC goals. Contact centres can, therefore, become an integral component of a broader population health strategy, facilitating both preventive care and chronic disease management.
Enhancing Patient Engagement with AI Integration
AI-powered contact centres can significantly elevate patient engagement by promoting proactive health management. Traditionally, contact centres aimed for operational efficiency, focusing on resolving patient inquiries quickly and with minimal interaction. However, AI-enhanced systems enable a more value-driven approach by providing agents with real-time patient insights, allowing for more personalised and meaningful conversations.
When integrated with EHRs, AI can recommend personalised health interventions during patient interactions, such as reminding patients to schedule follow-up visits, complete vaccinations or adhere to medication plans. Automation can also handle routine inquiries, allowing human agents to focus on complex cases requiring empathy and expertise. Additionally, natural language processing capabilities can empower virtual agents to handle straightforward queries, freeing up human resources for more critical tasks. This proactive approach not only improves health outcomes but also helps providers meet quality metrics and avoid financial penalties under VBC contracts.
Minimising Disruption While Driving Value
Adapting contact centres for VBC may seem complex and resource-intensive, but modern technology makes the transition manageable without major operational overhauls. Integrating existing EHRs with contact centre platforms allows for seamless data sharing, empowering support agents with valuable insights during patient interactions. This can be achieved without extensive staff retraining or additional resource allocation, making it a practical solution for organisations seeking to align with VBC goals.
Furthermore, self-service automation tools can extend the reach of VBC strategies beyond direct human interactions. Virtual assistants, chatbots and patient portals can help close care gaps by delivering personalised reminders and health recommendations, ensuring patient engagement even outside traditional care settings. By making clinical data accessible across all patient touchpoints, healthcare organisations can better engage patients who may face barriers to care, such as language differences, cultural factors or social determinants of health. This comprehensive approach ensures that proactive care management is a continuous process, further supporting population health strategies.
Expanding the Role of Contact Centres in VBC
The evolving role of contact centres in VBC extends beyond traditional patient support to become integral parts of proactive care models. Contact centres can support long-term health management strategies by providing continuous patient education, monitoring health trends and facilitating follow-ups on care plans. Real-time insights delivered through integrated contact centre technology can also help identify patients at risk of deteriorating health, enabling timely interventions that prevent costly hospitalisations.
Moreover, contact centres can contribute to health equity by reaching underserved populations who might otherwise experience barriers to care. By proactively addressing care gaps and ensuring data is available across multiple touchpoints, healthcare organisations can more effectively support diverse patient populations, ultimately leading to better overall health outcomes and reduced disparities in care.
Contact centres, once viewed purely as cost centres, have the potential to become critical drivers of value in the shift towards value-based care. By closing data gaps, integrating AI-driven insights and leveraging every patient interaction, healthcare organisations can transform their contact centres into strategic assets that support proactive care delivery. This integrated approach not only improves patient outcomes and financial performance but also drives greater population health success.
Source: Managed Healthcare Executive
Image Credit: iStock
