Patient engagement, consumer satisfaction, and patient access to healthcare are three of the most critical pieces of the value-based care puzzle.
As outcomes, satisfaction, and patient loyalty become more important to financial security for healthcare organizations, providers need to emphasize the use of person-centered care philosophies to ensure that patients can easily and affordably engage in the relationships they need to maintain wellness.
A non-partisan group of senators said it well in a letter urging the Senate Health, Education, Labor, and Pensions Committee to reassess patient access to care:
“We have heard from several patient groups with chronic diseases such as rheumatoid arthritis, inflammatory bowel diseases, and psoriasis, on the difficulties of accessing care and treatment,” the group wrote.
“Accessing the care needed is critical for these patients to achieve optimal health outcomes. Delays in treatment can result in irreversible disease progression and even, exacerbate the cost of care for both the patient and the health system.”
In order to avoid these negative outcomes and improve patient access to healthcare, industry professionals must work to understand the challenges patients face when seeking treatments and employ innovative strategies for mitigating those issues.
What are the challenges related to care access?
Offering sufficient access to healthcare services can present numerous challenges, especially in the arenas of availability, convenience, and affordability.
Offices that only conduct appointments during traditional work hours, for example, may be inaccessible for those who work during those times. Children going to school full-time may also be unable to see pediatricians with limited afternoon or evening availability.
Additionally, patients may face availability issues due to a potentially shrinking workforce, compounded by provider dissatisfaction. In a survey from the Physicians Foundation, 53 percent of providers reported low job satisfaction and 62 percent a negative view of the future of the medical profession.
According to the Foundation’s researchers, low provider morale could potentially lead to lower numbers of employed providers. Forty-eight percent of the survey’s nearly 17,000 clinician respondents reported plans to exit the trade, whether through retirement or a career transition.
“The primary public policy and healthcare concern attached to low physician morale is the prospect of physicians modifying their practice styles in ways that reduce patient access, or the prospect that physicians will abandon patient care roles or leave medicine altogether,” the report says.
With regard to affordability, increasing out-of-pocket patient costs have proven prohibitive for patients looking to access medical treatment.
According to a report from InstaMed, 74 percent of providers saw an increase in patient financial responsibility in 2015. High out-of-pocket costs can be prohibitive, causing some patients to skip recommended care. .
According to a seperate Physicians Foundation poll of over 1,500 patients, 25 percent are forgoing care due to cost burden, despite the fact that 90 percent reported high satisfaction with their providers.
Patients living in rural areas are the most likely to face challenges in accessing adequate healthcare, says the Rural Health Information Hub.
“Rural residents often experience barriers to healthcare that limit their ability to get the care they need,” the organization says. “In order for rural residents to have sufficient healthcare access, necessary and appropriate services must be available which can be accessed in a timely manner.”
In addition to facing the barriers patients across the nations face, those living rural areas are confined due to their locations and a lack of available treatment facilities.
“People in rural areas are more likely to have to travel long distances to access healthcare services, particularly specialist services,” the Rural Health Information Hub said. “This can be a significant burden in terms of both time and money. In addition, the lack of reliable transportation is a barrier to care.”
When patients have to travel long distances to receive treatment, as many living rural regions do, they are likely to go without adequate care.
Source: Think Stock
How does care access affect value-based care policies?
Through accountable care organizations – a value-based payment model hosted by both public and private healthcare payers – providers face incentives in offering strong patient healthcare access.
In order to succeed in an accountable care organization, providers should engage in strong clinician outreach to their patients, consistently extending care opportunities.
According to Mark Wagar, President of Heritage Medical Systems, the industry is moving toward a model of extending care services based on patient needs.
“One of our problems with our traditional healthcare system is that people go through too much build-up of their health problems before they seek care,” Wagar said.
“We’re moving far faster than ever before away from a system that is designed to be excellent for the patient when they present themselves because they are sick or injured to a system that basically envelopes them and engages with them non-stop,” Wagar explained.
Going forward with value-based care programs, providers should determine how expanding their care access can improve patient care. Patient engagement plays a central role in both MIPS and accountable care organizations, making care access imperative for their success.
How can providers improve healthcare access for patients?
In order to establish broad healthcare access, healthcare organizations should look at how they make themselves available to patients. This can include an assessment of digital communication strategies, appointment scheduling protocol, office hours, and how many providers are actually available for a visit.
When examining these issues, organization leaders must also keep in mind what their patient populations may want. In an increasingly consumer-centric industry, it will be important for healthcare organizations to offer treatment access in ways that are convenient for the patient.
As the industry landscape changes, providers may consider new services offerings such as telehealth, or alternative methods for getting patients scheduled and in the door such as online appointment scheduling. Those approaches, taken alongside expanding and supporting the provider workforce, could be effective in driving patient healthcare access.
Source: Think Stock
Enlist telehealth to offer remote treatment
Telehealth allows patients to consult providers through video conferencing, connecting two people in different locations and opening up numerous avenues for healthcare access.
Overall, telehealth helps expand access to care for two groups of patients: those in rural areas who live far away from a clinic or hospital, and those who have jam-packed schedules and may not be able to see a doctor during normal office hours.
In Georgia, the Community Health Systems clinic has benefitted from offering telehealth to its patients. Hosted by the Hancock County Healthcare Access Initiative, the telehealth platform allows remote patients to chat with a nurse via video conference using a toll-free number.
“It’s a way to bring some healthcare to people who don’t often see it, but who do need it,” said Dr. Jean Sumner, physician and dean of the Mercer University School of Medicine.
Some rural clinics also have telehealth kits that connect to larger regional hospitals.
At the University of Mississippi Medical Center, this setup allows patients to visit a local clinic, but still receive top-of-the-line care from a larger institution. Nurses in rural clinics can meet with doctors from UMMC’s level-one trauma center, and together they can deliver the best treatment for the patient.
Ultimately, this can enhance the entire patient experience. While patients still receive top-notch care utilizing tools only available at larger organizations, they avoid the hassle of traveling miles to receive emergency care.
Convenience is also a consideration for individuals with busy schedules. Full-time workers can use telehealth to conduct follow-up appointments during the work day. Parents can access providers via telehealth, helping to ease burdens that can arise when a child is sick.
A survey of over 500 mothers conducted by Blue Cross Blue Shield of Georgia shows that nearly 65 percent of mothers find it difficult to bring a sick child to the doctor during the work day. About 70 percent say sick visits take approximately two hours out of the day.
Florida-based Nemours Children’s Health System utilizes telehealth to help solve this problem, with parents reportedly appreciating this added convenience.
“Mom loves it because she didn’t have to pack up all the kids and drive two hours north for an appointment and then two hours back home,” said Nemours Chief Information Officer Bernie Rice. “So it was much more convenient for the patient and the family.”
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Improve scheduling processes
When patients do need to access in-person care, they often face complications with scheduling appointments. When contacting a provider’s call center or front desk to make an appointment, patients may encounter busy signals, technological issues, or troubles finding a time that meets both patient and provider needs.
According to Irene Vergulis, a medical call center consultant who has worked with organizations including Mercy Health and Temple University Health System, healthcare organizations should assess their appointment scheduling processes, bearing in mind patient needs.
“People need to understand that patients are still customers,” Vergules said. “People need to really start to take focus on what their access looks like. How easy is it to gain access to their providers, to their services, to their hospitals? I think people are still not really looking at that very critically.”
Providers may wish to consider how many administrative staff members are taking appointment calls, or how many appointments are available during a typical day. Conducting surveys and focus groups with patients will show where they may need to make improvements.
Healthcare organizations can also consider online appointment scheduling software, which allows patients to view and select appointments with their preferred providers, typically via the patient portal.
At MedStar Health, online appointment scheduling has not only boosted convenience for patients, but has allowed patients to see the right kind of doctor for their ailment, an issue the hospital had reportedly struggled with.
“If we don’t have a good mechanism to match the patient’s needs with the doctor’s capabilities, we run the chance of having a patient showing up and being seen by the wrong doctor,” said Michael Ruiz, Vice President and Chief Digital Officer at MedStar. “So what we want to do is kind of inverse that paradigm. If we get it right the first time, we create this win-win situation.”
When a patient with a knee injury books an appointment, he can make sure he sees an orthopedist who specializes in knees rather than one who specializes in shoulders, Ruiz explained.
By making sure patients can make appointments – and with the right doctor – healthcare professionals can help improve their access to healthcare, ultimately driving more patient-centered care.
Source: Think Stock
Expand and support the healthcare workforce
Fundamentally, patient healthcare access depends upon there being clinicians to actually treat them. As mentioned above, many physicians have reported job dissatisfaction and potential plans to leave the field. When there is a workforce shortage, patients ultimately lose out because there are not enough providers to see them all in a timely manner.
However, mid-level and non-physician providers are helpful for lower-priority concerns.
According to a 2014 report from the Medical Group Management Association (MGMA), non-physician provider (NPPs) are extremely effective at driving patient satisfaction, and ease some of the patient volume off of physicians.
According to Michael Brohawn, MGMA member and practice administrator at Orthopaedics East & Sports Medicine Center, NPPs have helped him enhance his practice.
“NPPs are essential members of our healthcare delivery team,” Brohawn said.
“They improve patient care by increasing the efficiency of our physicians which allows them to focus on more acute needs. NPPs also improve patient satisfaction by creating greater access and appointment availability, and they reduce the direct and overhead costs of the practice.”
Currently, the American Medical Association is working to redirect prospective physicians to provider shortage areas. The AMA’s Health Workforce Mapper uses data from the trade group to highlight where medical school students can look for employment opportunities, helping to more evenly distribute the physician workforce.
“Improving patient access to quality care is a core mission of the AMA, and this mapping tool will show physicians and healthcare professionals precisely where their skills can most benefit populations in need,” said AMA President Andrew W. Gurman, MD.
“Knowing where health care services are needed most can help providers make the best decisions on where to locate or expand their practices to reach patients in greatest need of access to care.”
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Address patient financial needs to ensure payment
In an effort to make it easier for patients to manage high out-of-pocket costs, some healthcare organizations are starting to offer payment plans. These plans allow patients to pay in increments, lessening the blow of a significant doctor bill.
Family Healthcare Group of Modesto started offering personalized payment plans, unique to the individual patient in need. According to the practice’s billing department manager, Tabitha Hickerson, CPC, payment plans have been met with high patient satisfaction.
“We definitely have a pretty wide spectrum of payment plans available for our patients and they seem to be pretty happy with it,” Hickerson said.
“As primary care physicians, our number one focus is patient care,” she continued.
“With patient out-of-pockets continuing to grow each year, we wanted our patients to be able to have the peace of mind to make treatment decisions based off of medical necessity and not their finances.”
Healthcare organizations can also curb a patient’s sticker-shock by practicing price transparency.
“What we see more of the innovative healthcare companies doing is simplifying the experience,” said Steve Auerbach, Chief Executive Officer of Alegeus. “This means making it easy for the consumers to understand how to save better and how to spend more efficiently.”
Price transparency shows patients that they have options when it comes to their healthcare, and helps them decide which services they should access that will be right for their budgets.
Patient healthcare access is ultimately rooted in meeting the patient’s overall needs. By making oneself available to patients, providers can ensure that patients receive treatment regardless of their circumstances.
Between providing remote care via telehealth and ensuring there are enough physicians to serve high patient volumes, healthcare access fundamentally requires flexibility and availability on the part of providers and scheduling administrators. In an industry that is increasingly consumer-centric, providers should consider adopting more flexible approaches, ensuring plentiful access to healthcare services.
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This article was originally published on November 29, 2016.