Basic Social Needs Are Driving Future Care Models

Chris has more than 20 years of experience in healthcare, with a focus on the physician enterprise in both practice plan and consulting environments. His experience includes administering practice plan operations as well as overseeing the delivery of comprehensive engagements at academic medical centers and health systems throughout the U.S. He has specialized expertise in the areas of physician solutions, children’s hospitals and cancer centers.
 

CS: As the Apples and Amazons of today inch closer to the point of care, they will certainly drive innovation in terms of how patients manage their health. Knowing this, there are two very important things to remember.

First, while many of these efforts allow self-sufficient consumers to proactively manage their health in more effective ways, they often omit the portion of society that needs the most help – people that are affected by chronic conditions and social determinants of health. These individuals account for the vast majority of healthcare spending and need much more than the latest gadget in wearable technology to address their complex needs. While they need more personalized care in order to understand and address their needs, these patients are thrust into our paradoxical episodic system of care. Many of these patients are finding themselves in emergency departments (EDs) anytime they need care.

Second, as more apps and care touch points are unveiled, while innovative, they are contributing to an abyss of disconnected health management initiatives. In most cases, we don’t need more technologies, we need more connected technologies. This is amplified in patients that require even greater levels of coordination and communication, such as pediatrics and oncology. Cancer patients, and especially the parents of children with cancer, require and expect prompt access, exceptional care delivery, evidence-based protocols and proactive communication -- all of which challenge current day technologies and care teams.
 

CS: While many physician organizations still largely rely on fee-for-service revenue, most are preparing for a shift to more preventative care in primary settings to avoid unnecessary hospitalizations and ED visits for their patients. To do so, physician offices need new modes of care that decompress the ambulatory office (e.g. evisits, virtual visits, telemedicine), and address the needs of patients with chronic conditions as well as increased demand.

In a recent analysis by Premier, ED visits from more than a third of patients with one of the six most prevalent chronic conditions were potentially preventable across nearly 750 hospitals. Additionally, in our work with more than 120 accountable care organizations (ACOs), Premier has observed that approximately 30 percent of ED visits could be addressed in primary care and other outpatient settings. That’s why the physician practices and health systems we are working with are actively engaging with each other to implement more comprehensive patient-centric, physician-aligned care management models.
 

CS: Patients generally opt to seek a new practice or location because of better access to care. While quality and reputation are essential factors, if the playing field is even, patients will prioritize practices that deliver prompt and convenient access.

However, same day appointments and family-friendly hours can be difficult to maintain, especially in medical groups that are well regarded and sought out as the first option by patients. Organizations need the ability to continually evaluate and manage access, capacity and optimal staffing models. It’s critical that medical group leaders make effective and timely decisions relative to practice growth opportunities and the need for additional providers.
 

CS: Patients with means are often willing to pay for differentiated healthcare services. Concierge medicine has become increasing popular due to its prompt and comprehensive approach. Additionally, integrated medicine has grown in popularity for patients with complex care needs and health conscious individuals looking for a more proactive model to manage overall wellness. These models place an emphasis on the long-term needs of the patient, often requiring that patients pay the provider directly, and then recoup a portion of the cost from their insurance plans.
 

To learn more about Physician Enterprise Services at Premier Inc., visit explore.premierinc.com/physician-enterprise-solutions.