July 26, 2017
Many of you are familiar with my philosophy that all clinical providers need to be empowered to “work at the top of their license.” It opens up additional access points for patients, eliminates waste, and provides a more responsive environment of care. It’s also great for employee morale when they aren’t constrained by the perversities of outdated fee-for-service payment schemes—and can actually deliver the care that they’re able to give.
I’m happy to report that we are putting that thinking into actual practice for Nurses, Medical Assistants, Clinical Pharmacists, Dietitians, and Counselors.
Several months ago, in our primary care network, the CCC incentivized this new effort by offering payment for encounters with the type of clinical providers named above (no other payer had traditionally paid for these patient encounters, so they didn’t happen on the whole). Better yet, the new kinds of encounters don’t always have to be face-to-face; patients can initiate contact via phone or portal in many cases.
In the short time that this practice has been in play, CCC’s primary care network provided over47,000 Nurse and MA encounters; 5100 Clinical Pharmacist encounters; almost 2,700 Dietician encounters; almost 300 behavioral health encounters. Thanks to the providers at CommUnityCare Health Centers, People’s Community Clinic, Lone Star Circle of Care, and El Buen Samaritano for opening up your care team and adapting your work flows to open up this kind of access to our patients.
I’m pleased to say that we successfully created incentives for providers to offer patients direct access to a broader care team; now, the physician isn’t likely the only face a patient will see. This is an early step to our broader vision of Value Based Care and it won’t be the last. How will these efforts pay off and subsequently bring Value to the Integrated Delivery System that we’ve been working so hard to create? We need more time and more focus to link these efforts more closely to quality measures before we can tell. This is not the end, it’s an intermediate step, and it’s already made a difference. I look forward to reporting other efforts and progress next month.