Value-based care represents a shift to a new type of care that is focused on improving the patient experience through the quality of care provided while being both efficient and effective. Payment to healthcare providers by the Centers for Medicare and Medicaid Services (CMS) based on quality – rather than quantity – was adopted in order to control increasing national healthcare costs. Meanwhile, the Patient-Centered Medical Home (PCMH) model is utilized by many healthcare facilities and providers to promote value-based care.
Here’s how healthcare leaders can foster improving care delivery within a PCMH, as well as effective strategies to improve the overall patient experience through value-based care.
Key Elements of Provider-Patient Relationships
The quality of patients’ communication with providers is a key determinant of patient satisfaction (per an article in Medical Care). Adoption of the PCMH model that is inclusive of a clinician as top-level care coordinator and regular (periodic) communication with patients is a strategy for improving the patient experience to boost patient satisfaction. Besides provider-patient communication, an article in Medical Care Research and Review describes the following as four other recognized elements of high patient satisfaction scores as analyzed from insurer surveys:
- Ease of scheduling appointments (which is frequently effective in improving patient experience)
- Availability of information (as pertains to treatment or prescribed medication for a patient’s health disorder)
- Coordination between providers (which is especially a PCMH focus for improving patient experience and overall care)
- Responsiveness of staff (which involves follow-up to patient-initiated phone calls and answers to patient questions)
Retaining patients is also affected by building better relationships through good communication that embraces a sense of trust by patients in the healthcare facility or clinician – as patients that trust their healthcare providers are more likely to provide high online quality ratings (that can affect other patients).
Link Between Preventive Care and Value-Based Care
Foundational to providing value-based care is improving access to preventive care. Chronic health disorders such as diabetes and heart disease affect 60 percent of all US adults and are linked to increased healthcare costs. According to a research article in 2018, improved chronic care coordination in order to control costs prompted a wide range of insurers to require the utilization of a PCMH to provide care for patients with chronic disorders. Easing the capacity for patients at risk for certain chronic disorders to obtain care is inherent in PCMHs through their “one-stop shopping” model of healthcare delivery inclusive of preventive care, which reduces the likelihood of developing (or worsening) chronic disorders.
Instead of providing care separately for medical exams, patient education, physical therapy, nutritionist services, and medication adherence monitoring, these may all be provided in the PCMH as a way to boost improving the patient experience (and particularly through the use of a common Health Information Technology [HIT] system).
Quality vs. Quantity in Healthcare Services and Hospitalization
Repeat hospital admissions for chronic disorders that are usually treatable in the outpatient setting was the primary focus of the payment penalties levied on hospitals with high re-admission rates. For the CMS (as well as private insurance companies), improved quality in tandem with cost-containment has been the goal of targeting preventable re-hospitalizations. (Since 18 percent of the US population is Medicare-insured, re-hospitalization financial penalties have created another incentive for hospitals to shift to value-based care – which has also increased the creation of Accountable Care Organizations [ACOs] to implement that value-based care.)
Four Strategies for Improving Patient Experience
The following are four specific strategies for outpatient medical practices to improve the overall patient experience (and, thereby, increase the likelihood of continued insurer network inclusion):
- Offer telehealth visits for patient follow-up (using teleconferencing software) to reduce the need for patients to travel to the outpatient practice site for the purpose of improving patient experience and overall healthcare quality improvement.
- Limit patient waiting times in the outpatient practice office to be seen by a healthcare provider to no more than 15 minutes for the purpose of improving patient experience and patient satisfaction.
- Perform patient outreach to provide appointment reminders, follow-up to determine patient adherence to medications, and reasons for any patient noncompliance for the purpose of improving patient experience and overall healthcare quality improvement.
- Utilize a Health Information Technology (HIT) system that enables a rapid receipt of patient’s hospital records for a person who has recently undergone surgery for the purpose of improving patient experience and overall healthcare quality improvement.
Ensure Your Staffing Levels Will Meet Your Needs
Hospitals and healthcare providers that are engaged in quality improvement activities aimed at improving the patient experience need to make sure their staffing levels are optimal.
At CareerStaff Unlimited, we specialize in helping healthcare organizations and facilities overcome workforce challenges and achieve successful clinical staffing plans. We help by providing access to a network of healthcare professionals and the support you need to make sure your staffing level is adequate in order to preserve patient satisfaction.