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.

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.

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.

As Season 2 of BoPC’s podcast keeps reminding us, relationship is a key component to high value health care. Certainly, frequency of visits aids in building a trusting relationship. But we sometimes forget that helping a patient feel cared for plays an even greater role. Proximity, touch, compassion, and empathy all facilitate this feeling. Sitting at eye level, within a few feet of a person shows them you’re engaged and, in turn, engages them.

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.

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.

Here’s another article in the medical literature that was needed to verify common sense – an all too frequent occurrence in healthcare, as we seem to often forget it (e.g., handwashing). This one deals with a well-known social risk.

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.

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.

As we continue the conversation around Advance Care Planning - it is important to educate your patients on the importance of these conversations.

Earlier this month, my practice converted from the Allscripts Professional PM and EHR system to athenaOne. If you have been through this process, you know it is not easy. Many have come to tears or left their job when going through a system conversion because of the stress of balancing seeing patients while learning a new system. While lessons were learned and there were hiccups along the way, our process went smoothly with only a 3-week ramp-up period.

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) announced a new primary care model aimed to improve health outcomes and better enable coordinated care with specialists to ultimately provide more seamless, high-quality, whole-person care. 

The business of primary care is a serious one and a unique one. Maybe you’ve always known you want to be in healthcare and primary care specifically, or perhaps you’re one of the many who, to use the Napoleon Hill term, “drifted” into your current role. However you got to where you are right now, what you and your practice do to serve your community is critical.

Noncompete clauses may become a thing of the past as the Federal Trade Commission (FTC) is expected to vote on its proposal to ban noncompete language in employment contracts in April of 2024.