This article is by Gareth Goh and originally appeared on the DataRobot Blog here: https://blog.datarobot.com/enterprise-ai-accelerating-healthcare-organizations-toward-value-based-care
For Symphony Care Network, typical payment models didn’t make sense for either the patients or the company. The type of patients they see at their facilities are post-acute patients, typically having recently had some type of orthopedic or cardiac surgery who are looking to stay for up to two weeks for rehabilitation. Given their unique model and to improve both quality measures and the company’s financial sustainability, they implemented -- with the help of DataRobot’s Enterprise AI platform -- a special patient-driven payment model around value-based care.
For a company with a complex patient population with many comorbidities, the previous model was a challenge to give patients the care they deserve while remaining financially stable.
Value-based care aligns better with quality measures, moving away from the previous Resource Utilization Group of billing patients to one that better takes into account how the patient is being treated at the facility.
DataRobot has helped CIO Nathan Patrick Taylor and his small team immensely by building highly accurate predictive models that can better align and predict quality measures. The DataRobot enterprise AI platform helps Nathan discover comorbidities, look for outliers and anomalies among patients, learn from progress notes to identify potential missed opportunities during billing, and understand what type of patient data drives payment.
“I tell our nurses that DataRobot and AI aren't going to make a decision for you,” said Nathan.
| “We’re not saying this machine is going to do your job for you. We’re saying we want this to be a tool in your toolbox to help you make decisions faster and look at the patient as a whole rather than just individual pieces.” |