Develop the Skills to Thrive in Value-Based Delivery Systems
Through a series of six online, on–demand courses and live workshops, PAMED offers educational programs to ensure physicians have the skills necessary to succeed in the transition from volume to value. The last live workshop is Oct. 9, 2015.
Learn more about online programs and live workshop.
Can volume to value succeed, from the physician’s perspective? The answer depends, in part, on patient behavior. Physicians must show that patients are healthier, but if patients don’t comply with orders and continue pursuing unhealthy habits, all the strategies put in place to see patients in the office and track their numbers could have little effect.
“We’re all on the same page with trying to come up with more and more innovative ways to improve patient adherence to physician recommendations,” says Christopher C. Clark, DO, MHA, medical director for Highmark’s clinical client relations team. “That’s a huge barrier. That’s why it’s not just a switch we flip and pay-for-value works every time.”
In this atmosphere, some physicians say that health coaches can play a vital role. While physicians concentrate on medical decisions, health coaches can be the liaisons who nudge patients into compliance and, if all works as planned, help improve health outcomes.
Health coaches can function in a number of ways that boost volume-to-value effectiveness, say physicians:
- Targeting high-risk patients. For example, the diabetic who hasn’t seen the physician or eye doctor in 18 months can be approached and encouraged to return, said Dr. Clark. Health coaches can “work side-by-side with the physician to connect with high-risk patients and get them to follow recommendations.”
- Working in multiple settings: Physicians can’t be everywhere at once. Health coaches can work in offices, hospitals, and emergency rooms, Dr. Clark said.
- Managing paperwork: The documentation required for volume-to-value can add hours to the physician’s day. Health coaches can be part of the team that documents care. Dr. Meena Agarwala is Assistant Professor of Medicine at Temple University School of Medicine, and a practitioner with Northern Valley Primary Care, St. Luke’s University Health System, Bethlehem. “I value the volume-to-value measures that are being implemented, and I understand conceptually that it is better care,” she said. “However, the time provided to meet clinical demands is not always adequate to fulfill the expectations of a busy family physician. It would be beneficial to have support staff to enable the physician to primarily focus on clinical outcome while having medical support staff ensure that all the values and essentials are being addressed adequately.”
As health coaches manage more patient outreach and documentation duties, physicians will be freed up to “take care of more people, because we’ll have more help,” said Paul Gausman, DO, family medicine, in Erie. Though there’s a cost to hiring, “it’s a commitment from the group saying that this stuff really matters, and we’re going to take on more overhead to make it happen.”
Dr. Agarwala suggests pilot-testing health coaches and other support staff, to determine if the costs are justified.
“Taking care of patients is what physicians do best, and letting them do that is to the ultimate advantage of the patient,” she said.