Over the past few years, the majority of legislation, innovation, reform and new reimbursement models swirling around the healthcare industry have been entirely focused on a shift from volume to value, compensating providers for maintaining or improving the health of patients through wellness and prevention, versus paying them a flat rate to only treat individuals when they are acutely ill.
For physicians, this is a great moment in time. After all, compensation based on better caring for individuals instead of how many individuals they can see each day is much more aligned with the care philosophies of most doctors. It should also be a wake up call, because delivering wellness, prevention and enhanced chronic care across a patient population is not an easy proposition.
In this environment, there is much that remains undecided. But the tip of the arrow has been well-formed. The shift from volume to value is coming, and it is coming quickly.
Effective wellness and prevention efforts only occur when patients are consistently engaged in their health and compliant with proactive plans. Meanwhile, most physicians will admit they are far from satisfied with their patients’ compliance with their care recommendations. Patients would agree. In one recent study of 1,000 consumers, 83% of patients said they did not follow treatment plans given to them by their doctors.
The good news for physicians is it isn’t a matter of trust that’s preventing patients from following orders. It’s the age-old concept: “out of sight, out of mind.”
Nearly half of respondents in the same study said they would do better following a plan if they received encouragement and support between visits. But that’s exactly the challenge.
Some studies suggest the typical American spends 30 minutes a year with his or her doctor. It’s a tall order to consistently deliver pizza in 30 minutes or less, much less wellness and prevention.
Even for the 14% of Americans who see the doctor 10 times or more per year, we can estimate the total time spent in the doctor’s office at around 5 hours. Just to put it in context, if a patient spent 90 hours with a doctor over the course of the year, that would still be less than 1 percent of his or her total available time. It’s a bit daunting to be on the hook for impacting a person’s lifestyle choices and overall health while being “out of sight, out of mind” for 99 percent of their existence.
As a result, physicians will have to find ways to round out their clinical expertise with resources that provide nutrition, fitness and emotional health support and by extending the support they provide between office visits to help manage health risks and chronic conditions. These advanced capabilities enable proactive management of patients, as well as enhanced care coordination, health education and reinforcement of physician care recommendations.
Because of the infrastructure and capital requirements involved, many physicians will need to find external partners who can integrate with the practice to fuel wellness activities. Whether developing these capabilities internally, or relying on an external, turnkey solution, physicians who want to be recognized as a top performer in a modern medical practice will have to effectively deliver wellness, prevention and care coordination across their patient populations.
The move from volume to value is happening. Physicians who embrace it and act swiftly will take full advantage of the opportunity. Those who don’t risk having the volume turned down on the value of their practices.
How are you making the shift from volume to value in your medical practice?