- Chronic disease patients tend to experience more healthcare challenges and incur higher costs, but with strong patient-provider communication and more convenient access to care, healthcare professionals can help mediate those issues, according to a report from the Commonwealth Fund.
By looking at responses from the nearly 1,805 patients categorized as high-needs in the 2016 Survey of High Needs Patients – meaning they were older, had lower levels of income and education, and had two or more chronic illnesses – the researchers determined that better assessment of patient needs can result in better care and potentially lower costs.
“With a better understanding of this patient population, health care providers would be more equipped to develop strategies for addressing behavioral health problems and unmet social needs,” the organization wrote. “These, in turn, could lead to improved medical outcomes and potentially lower health care costs.”
For example, high-needs patients require better connections outside the doctor’s office. Fifty-three percent of respondents said they see multiple doctors for different conditions. Of those patients, 43 percent said they have an up-to-date care coordinator, but another 38 percent said they depend on family and friends for help.
“The results suggest that the health care system is largely failing to meet the complex needs of these patients,” the report authors said. When patients do not receive proper care coordination or communicate with their providers, they are less likely to access treatment in an appropriate and cost-effective setting.
The survey showed that when patients do wish to seek care in the appropriate setting, 44 percent delay their care because they face barriers. Twenty-two percent say they can’t get rides to appointments, for example, and 29 percent said they can’t get an appointment quickly enough.
And although 95 percent of high-needs patients reported having a regular primary care physician, 65 percent said they can’t get a same-day response to a question or request.
Limited access to appointments can also produce financial issues. With 65 percent of patients saying it is difficult to get after-hours medical care without visiting an emergency department, organizations without extended hours may be inadvertently funneling patients into higher-cost care options.
Healthcare organizations and individual clinicians should consider expanding their office hours or increasing their digital communications with high-needs patients. By doing so, they can better direct patients into appropriate care settings – such as clinics or offices – keeping emergency department costs down.
“For high-need patients, having accessible after-hours care, being able to get a same-day answer to a medical question, and having a good relationship with their regular health care provider through patient-centered communication are associated with lower rates of non-urgent emergency department visits for conditions that could have been handled by a regular doctor if one had been available,” the Commonwealth Fund explained.
Providers can address external challenges through more creative strategies. For example, hospitals can offer ridesharing options through Lyft or Uber to help patients get rides to their appointments.
The researchers acknowledged that some patient needs will go beyond the scope of traditional medicine. Thirty-seven percent of respondents reported feelings of social isolation and 62 percent admitted to financial distress. The report says that healthcare organizations need to understand these unique issues and how they can affect health.
“Social isolation and material hardship, for example, have been shown to aggravate medical conditions,” the authors wrote. “Health care providers should build relationships and collaborate with social service agencies, community-based organizations, and behavioral health providers to deliver better outcomes and avoid high-cost care for this population.”
Ultimately, healthcare professionals must work with their high-needs patients to better understand their needs, especially because they may be different from the needs of their other patients. By doing so, they can better serve this population, eventually leading them to better care outcomes.
“The health care system is currently failing to meet the complex needs of these patients,” the report concluded. “High-need patients have greater unmet behavioral health and social issues than do other adults and require greater support to help manage their complex medical and nonmedical requirements.”