Patients and physicians differ in their definition of high-value care, a new survey finds, with patients favoring affordability and convenience while physicians think relationships with patients and outcomes are most important to achieve high-value care.
The survey, conducted by Leavitt Partners and commissioned by the University of Utah Health, emphasizes the disconnect providers have with patients as healthcare continues its transition to value-based care.
"As much as we talk about value in U.S. healthcare, a lot of that conversation has been driven by large corporations and lobbying groups...and there has been surprisingly little voice from those who actually receive care and those that provide care," said Dr. Bob Pendleton, chief medical quality officer of the University of Utah Health. "I think this creates some tension—we ought to be having these conversations nationally in a more robust and meaningful way to come up with a shared vision for what we want and need from a healthcare delivery system."
According to the survey, the top indicators of high-value care for patients were affordable out-of-pocket costs, the ability to schedule a timely appointment, confidence in the provider's expertise and that the office was conveniently located.
At the same time, physicians who responded to the survey said the best indicators of high-value were that they knew and cared about their patient, ordered the right labs and exams, their patient's health improved and they were able to spend a sufficient amount of time with their patient.
"A lot of those things that patients value like the ability to schedule an appointment or a convenient location, those are what traditionally physicians would view as patient experience, but patients would actually say those are indicators of quality (of care)," Pendleton said.
Patients increasingly expect their healthcare experience to include consumer-oriented services like mobile apps and extended office hours, yet providers are still behind in addressing those needs.
Pendleton said in order to resolve these differences, physicians need to be more open to having discussions with patients about what is most important to them as well as working with other clinicians to offer a more comprehensive healthcare experience for patients.
In fact, the survey found physicians feel they bear most of the responsibility—75%—regarding whether or not their patient's health improves.
"Physicians need to feel a little less personal responsibility and view their role as being effective team leaders and participants," Pendleton said.
Both physicians and patients did largely agree on one point, which is that it's the doctor's responsibility to discuss the cost of care with patients. "That is something we ought to be doing to improve care, yet currently those costs are opaque. Providers can talk in general terms but we really need to accelerate in equipping patients and physicians with having those conversations in a more meaningful way."