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Primary Care: Are You Busy Or Effective (or Both)?

May of 2018 we turned on dashboards on the Value of Care for a group of 400 providers. On the dashboard the scale of 0 – 100, a 70 was considered “good value,” below this there were significant opportunity for higher value care. The average score for our providers was 35.

Within hours the phones began to ring – “my care is better than this,” “my dashboard is wrong,” “your data is incomplete” – the general sentiment was “I am making a bigger difference that you are saying I am.”

Let’s look at the facts – they were busy – usually filling their schedule to 80+%, moving through the day giving 100% to each person sitting before them. At the end of the day going home feeling tired but sure of their contribution to their patients. They must be high quality, effective, and their patients are benefiting based on days, months, and years of committed work.

So why the relatively low scores? We set up teams to investigate. The ability to click down to a member level allowed the providers to see what was going on with their patients. Were the patient really theirs or not? An examination revealed YES! Then why weren’t their blood pressure, cholesterol, asthma, blood sugars, immunizations, and screenings not at goal?

Barbara was supposed to come back in but never did, Bob travels all the time, Suzie stopped taking her meds, but never communicated it, John’s son got ill and he missed his appointment and never came back in…. The list of reasons went on and on. But the reality did not change – we were confusing being busy with meeting the needs of our patients. Often, we were not seeing the patients that needed us the most.

This lead to new systems, new ways of proactive (and automated) outreach. Soon the right patients were in the right practice at the right time. Quality took a jump up. Providers knew they were doing the best thing for all of their patients, not just the ones in front of them.

Busy was now productive and we were adding years to the lives and life to the years of those we served!

Is your practice busy, effective, or both?

Forbes Reports States Fail on Transparency – How Are You Doing?

 

By DrScott – Posted on March 27, 2014 on www.compassphs.com

Transparency transforms employee’s relationship with health care. Actionable data delivered in a way that allows informed decision making has the potential to save tens of millions for both organizations and individuals at risk for health benefit expenditures.

The Accountable Care Act requires making transparency information more available and actionable for the public. This article points out that our states have not navigated this challenge successfully – yet. As Suzanne Delbanco executive director for Catalyst for Payment Reform states, “As much discussion and activity as there is around transparency, the truth is that today it’s a very rare instance when a consumer can easily find meaningful information about health care prices. We’ve got a long way to go.”

The challenge is even bigger than this article acknowledges. In order to go from an F to an A in the state transparency ratings, all that had to occur was for the data to be put on a web site. As the article states “In order to get a good grade, the groups say a state needs to provide public access to a “fully functioning website” as well as ensure regulations on price information are accessible for a long period of time.”

Engagement data suggests that having access to a web portal is only a beginning. Translating the web information into action often requires human support and interpretation. The moment questions like “is the MRI with or without contrast” are asked, many users are stumped and abandon their transparency exercise.