iLoveBenefits: Industry News Blog

They may be ‘satisfied’ but are they getting the value they need?

Most Health-Insured Adults are Satisfied With Their Primary Care Physician

Salesforce recently released its 2016 Connected Patient Report on adults who have health insurance and a primary care physician. Here are some key findings from the report:

  • 91% of patients are satisfied with their primary care physician.
  • 3 in 4 patients (76%) use phones to communicate with their doctors and set appointments.
  • 62% of patients rely on their doctors to manage their data, while 29% keep their records at home.
  • Half of health-insured patients (48%) report having the same doctor for the past 10 years.
  • 1 in 3 patients feel their doctors would not recognize them walking down the street.
  • 62% of patients would be open to virtual care treatments as an alternative to in-office doctor visits.

Source: Salesforce, June 27, 2016

Building a closed loop process enabling in effective hospital discharges

This is a project funded by AHRQ that is building an infrastructure to support initiatives to reduce avoidable hospital readmissions.

Buffalo, N.Y., university to develop follow-up care pilotThe University at Buffalo School of Nursing received a two-year grant from the Agency for Healthcare Research and Quality for a care transitions program. The grant is to be used for the development of a pilot project designed to ensure appropriate follow-up care after patients are released from the hospital to reduce the need for readmissions and emergency care. Healthcare Informatics online (7/29)

Clinic delivery of health care is taking hold

According to a recent study of Walgreens retail clinics:

  • Patient visits for preventive services, screening and chronic health services (combined) rose from 4% in 2007 to 17% in 2013
  • Return patient visits to the retail clinics rose from 15% in 2007 to more than 50% in 2013
  • For patients age 17 and under, visits for both preventive services and vaccinations rose by 180%
  • For patients ages 18 to 64, visits for health testing rose by 90%, and preventive service visits rose 66%
  • Acute care visits rose 84% for patients age 65 and older

Source: “More Patients Turning to Retail Clinics for Chronic Care and Preventive Services, New Walgreens Study Shows,” Walgreens Press Release, July 17, 2014, http://news.walgreens.com/article_display.cfm?article_id=5882

Enlarging the definition of the Primary Care Workforce is Critical

Geographic Distribution of Primary Care Workforce

Nurse practitioners Physician assistants Family physicians/GPs General internal medicine General pediatrics U.S. population
Urban 72.20% 75.10% 77.50% 89.80% 91.20% 80%
Large rural 11.00% 11.70% 11.10% 6.70% 6.20% 10%
Small rural 7.70% 6.90% 7.20% 2.40% 1.80% 5%
Remote rural 9.10% 6.30% 4.20% 1.10% 0.80% 5%

Source: Agency for Healthcare Research and Quality

ACO and Patient Patterns

It is early and this data is even earlier. Initial indications of patient patient patterns as we enter the world of Medicare ACOs.

  • 80.4% of Medicare beneficiaries who were assigned to an Accountable Care Organization (ACO) in 2010, were assigned to the same ACO in 2011, and 19.6% were not
  • Among ACO-assigned beneficiaries, 8.7% of office visits with primary care physicians were provided outside of the assigned ACO
  • Among ACO-assigned beneficiaries, 66.7% of office visits with specialists were provided outside of the assigned ACO
  • 37.9% of Medicare spending on outpatient care billed by ACO physicians was devoted to ACO-assigned beneficiaries, and 62.1% was not

Source: “Outpatient Care Patterns and Organizational Accountability in Medicare,” JAMA Internal Medicine, abstract only, April 21, 2014, https://archinte.jamanetwork.com/article.aspx?articleid=186103

Providing a written plan. . . of care

Most cancer patients enter survivorship with little direction from oncologists or primary care providers, according to a national survey.

Two-thirds of 1,130 oncologists said they always or almost always discuss survivorship with patients, but only a third told patients where to seek cancer-related or other care. Fewer than 5% of oncology respondents provided patients with a written plan for survivorship care.

Read more here: Of 1,020 primary care providers surveyed, 12% reported regular discussions about recommendations for survivorship care or provider responsibility, as reported online in the Journal of Clinical Oncology.

Most who follow me know that I have a vision for how health care will evolve. The next two big things that need to occur are transparency of pricing – what patients are expected to pay for the services they receive – estimates if not actual prices based on the insurance they have and the current terms of that insurance. And not necessarily in this order a plan of care.

Let me explain what is meant by a plan of care. It goes well beyond the story in the Journal of Clincal Oncology. That is just one example.

It is a plan that every person should have. It is the equivalent of a financial plan. It is something that the patient has the key to access, a portal and a document through which to view and understand their medical condition and the actions that they or their caregivers need to take to optimize the outcomes that patient is seeking. It is something that the patient enables others including their providers and caregives to view and to add to with their special knowledge and information. It spans every episode of care. Whether that is a prevention episode, a wellness episode, an acute episode, a chronic episode, even a secondary prevention episode.

It enables hospital discharge instructions to be cleanly handed off to family caregivers, rehabilitation caregivers, other physcians or nurses caring for the patient. It enables the primary care physician to view what all other parts of the health system are contributing to the health of the patient. It provides a means of communicating with the patient while in the office and to be sure that the instructions are clear when they leave the office. It helps turn the office visit into a counselling session rather than simply a visit and script.

It links physician to nurse, pharmacy to physician, hospital to rehab or nursing facility. It helps turn siloed health care services into a system of organized and informed health processes focused on the patient.

Three quarters of elderly patients prefer coordinated care, but most don’t get it

Most older patients prefer coordinated care but few receive it, survey finds
A survey by the John A. Hartford Foundation revealed 73% of elderly patients said they would prefer coordinated care from a team of medical professionals, but only 27% reported receiving such care. Researchers also found that 48% of older patients said they would consider switching primary care doctors if coordinated team care is available elsewhere. BeckersHospitalReview.com (4/3)

Self care is beginning to come of age

The rise of the empowered patient
A woman who diagnosed her own rare genetic disease represents today’s “empowered patient,” said cardiologist Dr. Eric Topol, who interviewed her at the Future of Genomic Medicine conference. Kim Goodsell identified the cause of her irregular heartbeat and other symptoms as a type of Charcot-Marie-Tooth disease, and she pressed her physicians for genetic testing. One of her doctors subsequently listed her as a co-author of a case study he is preparing to present to the Heart Rhythm Society, saying she did the majority of the work. San Diego Union-Tribune (3/7)

Relationship quality in primary care settings

Researchers create tool to assess work relationships in primary care
Researchers at the South Texas Veterans Health Care System in San Antonio have developed and validated the Work Relationships Scale, which is designed to assess relationship quality in primary care settings. Data published in the Annals of Family Medicine showed that WRS scores significantly correlated with overall health care and personal physician/nurse ratings. PhysiciansBriefing.com/HealthDay News (1/2)

Clues around improving care coodination

According to a recent
survey, Patient-Centered Medical Homes (PCMH’s) reported a median of 29 total
full-time-equivalent (FTE) support staff per 10,000 patients, compared with
18.5 total support staff FTEs per 10,000 patients for those not in PCMH’s.

Source: “Total
operating costs per patient higher in patient-centered medical homes; higher
revenue also reported,” Medical Group Management Association (MGMA)/the
American College of Medical Practice Executives (ACMPE) Press Release,
September 17, 2013, http://www.mgma.com/press/default.aspx?id=1375506

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