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WellSky® Survey Finds Physicians Struggle to Connect With Post-Acute Care Providers, Need Better Technology to Succeed in Value-Based Care

Majority of respondents rely on manual and time-consuming processes and lack the data and tools they need to deliver effective patient care

OVERLAND PARK, Kan. – December 6, 2023 – WellSky, a leading health and community care technology company, today released results from a survey of physician leaders in ambulatory care that found 75% of respondents do not have established partnerships with post-acute care providers. For those who do, communication between the clinicians and other caregivers takes place primarily over the phone, leading to a lack of visibility into their patients’ care journeys.

While 86% of physicians surveyed receive an alert when their patients are admitted or discharged from a hospital, only 63% are notified when one of their patients is sent home from a post-acute facility. This could be because 84% of respondents still rely on manual processes like phone calls to manage care transitions.

“Ambulatory care providers need a technology-driven approach to efficiently and effectively manage patients and influence their care transitions,” said Dr. Lissy Hu, president of connected networks at WellSky. “With WellSky’s comprehensive post-acute referral network, data analytics, patient choice tools, and closed loop referral capabilities, providers gain enhanced visibility into the entire patient journey enabling them to better coordinate care as patients move through the continuum.”

3 of 4 survey respondents expect their participation in value-based care programs to increase over the next few years. Success in value-based care will depend on connected networks, and the ability to manage patients as they move through the care continuum. WellSky powers more than 52 million referrals to post-acute care each year and offers the largest end-to-end care coordination network, connecting more than 2,000 hospitals and 130,000 post-acute providers – including home health agencies and other home-based caregivers.

One-third of home health episodes are referred by ambulatory physicians, and according to the survey, most referrals are sent by either fax (50%) or phone (40%). Survey respondents reported their biggest challenges are managing referrals from a wide variety of care settings and delayed responses from post-acute providers. Additionally, 78% of physicians surveyed said they are concerned about their patients’ post-acute costs.

Medicare reimburses some services under Transitional Care Management (TCM), which can provide extra revenue to providers, however 57% of the physicians surveyed said they do not participate due to challenges such as staffing constraints, the availability of timely data, and lack of technology to help better manage patient populations.

WellSky solutions help providers facilitate TCM outreach and requirements, with two WellSky clients seeing a 49% increase in TCM encounters, a 44% increase in revenue year-over-year, and a 2.3% decrease in hospital readmissions.

“The healthcare system is extremely complex, with different types of providers in many varieties of care settings,” said Hu. “WellSky brings together one of the largest networks of physicians, caregivers, payers, and ACOs in the nation with two goals in mind: enabling safe and efficient patient transitions between those settings and facilitating seamless communication among the entire care team. With the right technology partner on their side, providers can achieve better outcomes and lower costs.”

To see more insights from the ambulatory care provider survey, visit

Media Contact 
Emma Neal
Phone: 617.401.3131

About WellSky®

WellSky is one of America’s largest and most innovative healthcare technology companies leading the movement for intelligent, coordinated care. Our proven software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations scale processes, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care. WellSky serves more than 20,000 client sites — including the largest hospital systems, blood banks, cell therapy labs, home health, and hospice franchises, post-acute providers, government agencies, and human services organizations. Informed by more than 40 years of providing software and expertise, WellSky anticipates clients’ needs and innovates relentlessly to build healthy, thriving communities. For more information, visit

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