Although challenges remain, physician practices transitioning to value-based reimbursement systems see positive results on many fronts, according to a new study from the RAND Corporation, sponsored by the American Medical Association.
Not only are practices learning to enhance patient care with their own teams of allied health professionals, but primary care physicians participating in global capitation or shared savings models also collaborate more often with specialists to better manage patient care, according to the report.
Practices that have joined accountable care organizations (ACO) or become patient-centered medical homes (PCMH) are also making great strides when it comes to care coordination.
"We have access to nurse care managers now, and clinical communication centers staffed by RNs to help us manage patients after hours--things we didn't have before that are driving toward a higher-quality outcome that we just couldn't have done on our own as a small independent practice," James Dom Dera, M.D., co-owner of The Ohio Family Practice Centers, told AAFP News Now about aligning with an ACO and achieving PCMH recognition.
A recent post from Medical Practice Insider echoes thoughts on the value of adding care coordinators or care managers to a practice, who can implement care plans set by providers, help monitor patients between appointments, provide ongoing medication reconciliation and provide quality reporting.
"It is important to note that the care coordinator does not necessarily need to be a nurse or other licensed healthcare professional, meaning that the cost of hiring a care coordinator is relatively low," noted the post. "The level of experience required will depend on the care coordinator's level of involvement in the care plan." Alternatively, practices can hire outside companies to provide care coordinator services for even lower cost.
Finally, patients seem to embrace a more coordinated approach. In a recent column for Boston Globe Magazine, for example, internist Judith L. Steinberg, M.D., described her own experience of being treated for kidney cancer up through recovery.
She wrote: "Throughout the process, there was solid communication between the surgeon and my primary care provider, in part because my PCP had electronic access to my hospital records and I took the initiative to e-mail her myself. After my discharge, I also prompted follow-up calls with both my surgical and primary care teams. … Was it special treatment for a doctor? New healthcare models would make it standard practice for everyone."
Steinberg did note, however, that her own and others' experience could be vastly improved with behavioral health integration, adding that there is a widespread need for services related to mental health throughout medicine.