- Healthcare organizations are increasingly recognizing the imperative for patient-centered care in value-based payment models, but very few are adequately incorporating the patient voice into their strategies, according to a recent report from the Health Care Transformation Task Force (HCTTF).
“The transition to value-based payment has generated more momentum for implementing high-quality, patient-centered care and involving the consumer voice in shaping the new system of value-based care; however, significant opportunities remain to improve engagement in the design, implementation, and oversight of value-based care models,” the report authors wrote.
In a survey of senior-level decision-makers at 13 healthcare organizations, the researchers found that a majority (92 percent) have ramped up their efforts to involve consumer input in “recent years.”
“There is a realization that consumers need to be engaged not just as patients but as participants in the value model design and governance of our delivery systems,” HCTFF executive director Jeff Micklos said in a statement. “Providers clearly have an opportunity to better involve consumers.”
About 62 percent of respondents said their organizations feature some form of “patient and consumer engagement” in their value statements.
Many of the survey respondents had the following patient activation structures in place:
- Patient and Family Advisory Councils;
- Advisory Boards with Consumer Representation;
- Quality Improvement Committees;
- Community Benefit Taskforces;
- Patient Advocate Offices;
- Corporate Boards with Consumer Representation;
- Boards or Committees Designing Alternative or New Care Models;
- Shared care/ shared decision-making systems;
- Portals of websites for gathering consumer insight; and,
- Focus groups for gathering consumer input, and Patient experience surveys.
Despite these many efforts, organizations reported that they are falling behind on involving patient voices in engagement activities. Most of the respondents stated that identifying and onboarding consumer stakeholders, limited staff resources, and an implicit resistance to organizational change keep them from effectively tapping the patient voice during practice improvement.
Organizations are also having trouble leveraging the health IT necessary to fully engage their patients and consumer decision-making partners. For example, most organizations offer patient portal access but face challenges in meaningfully using the tool.
Practices are struggling with funding, limited interoperability between portals and systems, and difficult patient recruitment on the portal.
“One participant described how consumer focus groups were integral to design and improve their consumer-facing portal,” the report noted. “Evaluating the success of consumer-facing portals – and consumer input in the portal development – remains an area for future analysis, considering the level of investment many providers are making in health IT.”
Organizations who reported robust and meaningful consumer engagement in organizational improvements cited highly engaged patients and strong leadership on committees. Key stakeholders were invested in their organizational efforts, and patients were truly activated in helping to improve the practice.
Medical practices that struggled in harnessing the patient voice cited varying levels of receptiveness to the endeavor. Although many organizations have established patient and family advisory councils, some of them ignore the insights the bodies offer.
“The underlying takeaways seemed to be that a sweeping culture change is needed to help shift the way things have always been done,” the report pointed out. “Also, provider organizations need additional expertise and assistance about how to best engage consumers.”
Organizations need to work on teamwork and collaboration to better engage patient stakeholders, according to Susan Sherry, deputy director at Community Catalyst.
“The goal to fully engage patients as meaningful partners in design, implementation and governance of value models is well accepted,” Sherry explained. “Yet, the practical challenges of achieving that goal are significant, especially in the context of the usual ways of doing business. All stakeholders must commit to working together to find new ways to make this vision a reality across the country.”
Healthcare professionals may also consult leaders from community healthcare organizations, who face federal mandates for patient involvement in value-based care. Federally Qualified Health Centers (FQHCs), for example, require 51 percent of their boards to be comprised of community members.
FQHCs have developed best practices that may be helpful for other organizations that do not face the same patient-centered care mandates.
Additionally, the report offered four recommendations to improve patient involvement in value-based care models:
3.Operational structure to support consumer engagement; and,
4.Integrations across “silos of patient engagement” within organizations (i.e., marketing, care management, wellness promotion, and technology to support consumer engagement).
“As the health care industry continues to strive towards the implementation of consumer engagement structures at both the system and local level, there exists a great opportunity for community-based organizations and community health centers to share their expertise and experience with other stakeholders,” the report concluded.
“Further multi-sector dialogue and execution leadership from provider organizations is needed to identify and scale successful consumer engagement strategies in the pursuit of person-centered, value-based care that keeps the patient at the center.”