Physician Perspective: Volume-to-Value Can Dovetail with Workplace Wellness

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Increasingly, employers rely on workplace wellness programs for cost-effective solutions to employees’ health concerns. At the same time, physicians are adopting pay-for-value approaches with the same goals.

Standing at that intersection, doctors can turn to wellness programs as possible resources to help assure success of their volume-to-value strategies, said Christopher C. Clark, DO, MHA, medical director for Highmark’s clinical client relations team.

Employer wellness programs address many of the same lifestyle issues that physicians wrestle with, including identifying and managing chronic diseases, said Dr. Clark. Wellness programs and value-based practices all seek better quality, better outcomes, and lower costs.

“It clearly connects to all that’s being done on the provider side in how patients are connected to their physicians, how they access care differently, and how they access pay,” Dr. Clark said.

Although wellness programs might not address the individual needs of each employee, physicians can embrace aspects of workplace wellness as tools for targeting those most in need of their care. The foundational role of primary care physicians is to oversee patients’ overall health, whether through acute care visits or managing chronic conditions, Dr. Clark notes.

The more effective the care, the better patients do, and “there’s the linkage back to the employer side. If a chronic disease is managed more effectively, they’re better able to work. Productivity improves, and the cost of care improves.”

Physicians can utilize several strategies at the intersection of pay-for-value and workplace wellness, according to Dr. Clark:

  • Wellness programs often identify chronic but undetected diseases and notify physicians. Biometric testing can detect such conditions as high blood pressure or diabetes at early phases.
  • Many workplace programs offer supports that promote better health through lifestyle changes, including weight management, physical activity, nutrition counseling, and tobacco-use cessation.
  • Highmark tries to link client wellness programs with pay-for-value physicians whenever possible “because it’s a proven solution, to improve quality of care and reduce costs,” Dr. Clark said. Employers, too, are showing “a lot of interest” in pay-for-value and trying to divert employees to physician practices or groups with strong track records of delivering high-quality, cost-effective care. Those relationships are likely to continue growing, Dr. Clark said, as employers “consider what’s most applicable to their employees and explore methods to at least educate their members on the most successful relationships and providers in an area.”
  • Some physicians are partnering with large employers to establish schedules of workplace office hours. Health care in the workplace improves access and “may be a model that can help with the pay-for-value piece by definition, meeting quality expectations and reducing costs and unnecessary utilization.”

Encouraging patient participation with doctors’ orders and with wellness programs remains a challenge, but the metrics physicians use in pay for value “have the same goals that wellness programs want to achieve,” Dr. Clark said. “Pay for value is baked in and is part of solution, because physicians have the expectation to meet metrics for delivering evidence-based guidelines for the diabetic in their population, for the high-blood pressure patient. If and when they accomplish those metrics, more people will be successfully managed. Outcomes will be better, and the (cost of) care will be lower.”