Improving patient outcomes while reducing readmissions with data analytics
St. Joseph’s Health is a world-class health system, serving New Jersey and the New York metropolitan area, caring for over 421,000 patients each year. St. Joseph’s Health clinically integrated network, St. Joseph’s Health Partners, participates in multiple value-based programs, including Mission Health Coordinated Care, a Medicare Shared Savings Plan ACO, several Medicare Advantage contracts, Comprehensive Care for Joint Replacement, Quality Improvement Plan – New Jersey and previously, the Bundled Payment for Care Improvement Advanced Program.
With the need to reduce readmissions from their growing skilled nursing facility (SNF) network and ensure appropriate length of stay, St. Joseph’s Health began to identify solutions to improve the total cost of care. With no way to track patients’ day-to-day care and outcomes once moved from acute to post-acute care, they could only react to data gleaned from admission, discharge, and transfer (ADT) feeds and claims. Current, actionable information to improve care collaboration and reduce readmissions was needed. With the implementation of Real Time Medical System’s post-acute interventional analytics solution, St. Joseph’s Health finally had a way to proactively meet readmissions challenges with clinical line of sight to their SNF patients.
