The first article in this series focused on the basics of telehealth for primary care. This included definitions, benefits, and examples. If you haven’t read it yet, check it out here! Now, we’re going to dive deeper into telehealth innovations and challenges. I’m excited for the future of telemedicine opportunities, and hope you are too. 

Virtual healthcare services use skyrocketed during COVID. It dramatically changed the way the world did work and school and shaped how we practice medicine. 

Previously, encounters were limited to patients coming into the office and being seen. There were quite a bit of phone calls, and some Inbasket electronic messages. Occasionally, someone was doing virtual appointments or had a specialty service dedicated to this. Some hospitals had begun using tele-stroke providers or tele-Intensive Care Unit monitoring. But few primary care practices incorporated it into routine services.

At the Reimagining Primary Care (RPC) Forum this spring, a prevailing theme about how primary care can and should be done in the future was one of team-based care. Our current paradigm of primary care comes with some mismatches, even conflicts to the notion of care delivered by a team, and this leads to challenges in transforming care.

Medications, both prescribed and over-the-counter (OTC) play an enormous role in American healthcare. According to the Centers for Disease Control, 71.9% of ambulatory office visits involve the prescription of a medication, and about 8% of all healthcare spending involves a prescription medication.

At the Reimagining Primary Care Forum this spring, Joel Brill, MD moderated a panel discussion on how to build the future of primary care. Dr. Brill asked the panel what one thing they would change in primary care if they had a magic wand.

Patient financial responsibility plays a significant role in revenue management. As out-of-pocket expenditure continues to rise, healthcare providers face challenges in collecting payments, leading to increased accounts receivable (A/R) and uncollectible revenue. Understanding the impact of patient responsibility and implementing effective strategies are essential for maintaining financial stability and delivering quality care.

In primary care, the concept of patient engagement has emerged as a key driver of improved patient outcomes. Imagine a scenario where every patient not only leaves the clinic with a treatment plan but also with a clear understanding of their role in their health journey.

I had the honor and pleasure once of sitting in on a broadcasted conversation with Faisel Syed, MD on the Sacred Patient-Physician Relationship. (Faisel and Friends) That discussion got me thinking more about the special rapport needed between the Person we call the Patient and the Healer for healthcare to be effective and to optimally create value.

One of the first and most important challenges an organization faces when moving from strictly fee-for-service (FFS) healthcare delivery to value-based care (VBC) is aligning physician and provider compensation to the new priorities of VBC. If this gets left to be done “later” or not at all, the disconnect between incentives will make VBC success very difficult. 

We have an unfathomable amount of data available to us today in healthcare. Beyond our clinical data, we have multiple discrete fields of other bits and bytes that we can look at to discover better ways to care for our patients. Sometimes, though, in our zeal to find problems or solutions, we get things a bit wrong in putting the data together into useful, actionable insights.

As a follow-up to the VBC Drivers article on Preferred Provider Networks, this article will focus on the importance of at-risk Primary Care Physicians engaging Specialty Physicians in driving Value-Based Care (VBC) outcomes through the development of High Value Networks (HVN) for continued performance improvement in VBC models.

A good proportion of healthcare delivery in the US happens on the fly. Even when an office visit is scheduled in advance, many practices don’t start any work on a patient until they see the whites of their eyes. Mrs. Jones shows up, and we look through the chart to see what needs to be done in the moment. This approach opens the door for inefficiency, ineffectiveness, missed opportunities, poor experience, and low-quality outcomes.

Throughout this series of articles, we’ve discussed value-based care (VBC) drivers of gross income – attribution, risk coding and activities-based bonuses – and spent a good amount of time on drivers of net income, those that lower medical expense. Of these, we have looked at access, Annual Wellness Visits, and managing patient care. These six levers get pulled by most all organizations and practices to some degree regardless of their position on the VBC spectrum.

In this series on the drivers of success in value-based care (VBC), we’ve looked at elements that improve gross revenue and are halfway through the discussion of VBC components that help decrease medical expenses. This installment will tackle the complex topic of “Care Management,” so buckle up and hang on!

This series has been focusing on levers to be pulled that can increase revenue in value-based care (VBC) practices. The second installment started looking at ways to decrease medical expenses, thereby increasing the potential revenue through shared savings or premium risk (Link to Part 2). Part 3 will now dig into the Swiss Army Knife of VBC, the Annual Wellness Visit (AWV).

As more practices and organizations pursue the principles of value-based care (VBC), they look for ways to improve their financial outcomes, the drivers of net revenue. Part 1 of this series focused on some of the main determinants of gross revenue in VBC and how to increase the size of the gross revenue bucket, or pie, depending on how hungry you are. These next installments will speak to the ways of decreasing medical costs, thereby increasing the risked savings to be shared or kept, decreasing the amount of pie eaten by medical expenses, thereby increasing the remainder in the bucket after expenses are paid.

We’ve become very familiar with the revenue drivers in fee-for-service (FFS) healthcare delivery over the past 100 years. Find the highest priced visits, treatments, and procedures a doc can perform and run as many patients as possible through those visits, treatments, and procedures. Since reimbursement rates for medical services have been going down, net revenue increases have more recently been driven by adding new types of visits or procedures to a practice’s repertoire and constantly honing efficiencies in moving people from the front door, through the exam/treatment room, and back into the parking lot as quickly as possible.

The Health Care Payment Learning and Action Network released a measurement of Alternative/Advanced Payment Models (APM) for 2023, showing the types of payments physicians and providers received overall and based on payer type. The measurements show a positive trend toward value-based care (VBC) payments, and the breakdown by payer was even more telling.

First impressions have always gotten a lot of attention, but I’m going to push back a bit and suggest that what happens after that first impression (aka unconscious bias) might need more focus. This MA, I’ll call them “Bleu,” was able to create a safe space for the patient and family member that overcame their initial judgment. Let’s explore how they did that, and how you and your team can focus on this too.

If you’re new to Value-based Healthcare, first of all, Wake Up! Where have you been? Just kidding. Even though I’d like to think that the concepts and practice of value-based care (VBC) are well-known to all and practiced diligently by most – VBC as a mode of operation in healthcare delivery that improves outcomes, improves patient and physician experience, improves revenue for physicians, and decreases overall cost of medical care – the realist in me recognizes that’s definitely not the case.