Archive for May, 2007

Value-Driven Healthcare in Action: A Four-Pronged Approach to Meet Consumer Transparency, Quality and Access Demands

May 24th, 2007 by Melanie Matthews

A lack of trust in the use of patient health information and a general reluctance to share patient information with industry competitors are the biggest obstacles to an open exchange of patient health information, says Gary Austin, a healthcare industry consultant on corporate/product strategy and program management. In spite of these roadblocks, the health plans he’s met with support a climate of value-based healthcare choices. Many plans have already invested millions to equip physicians with the capability for e-prescribing, and more will underwrite physicians in the use of electronic medical records in the next few years. He envisions that consumer “smart cards” loaded with patient health information will initially be introduced within individual health systems, and eventually be usable between systems.

A physician practice’s measurements reporting efforts will flourish under a “physician champion” to lead the way, notes Linda Davis, a consultant to the Buyers Health Care Action Group (BHCAG) in Minnesota. Once a transparent reporting effort is underway, it can bring about significant cultural change and raise motivation levels in the naturally competitive provider environment, she adds. Aware of the automated vs. manual reporting methods in use, the BHCAG facilitates the reporting effort via its direct data submission process, which accepts data from practices in many formats.

Rewarding members and employees for being savvy medical consumers and shopping is an increasing trend in healthcare, notes Sue Lewis, senior vice president of health and productivity solutions at IncentOne. Companies are leveraging the corporate Intranet, meetings and health fairs to spread the word on incentives to their populations. She has also observed that companies offering consumer-directed health plans are in the best position tax-wise to extend benefits to dependents and retirees.

Until patient satisfaction ratings can be evidenced to be linked to outcomes, they should not factor into a provider’s quality ratings, says Mark Xistris, director of provider relations & health information for The Alliance, an employer-owned and directed not-for-profit cooperative that helps companies manage the total cost of ensuring the health and well-being of their workforce. His organization, recently named a community leader by the U.S. Department of Health and Human Services, believes that providers and payors have legitimate concerns about releasing cost information to consumers, who may misinterpret the data without proper guidelines.

Austin, Davis, Lewis, and Xistris, examined how their respective organizations are using these four strategies to stay competitive in the fast-growing consumer-driven movement during a May 30, 2007 audio conference, Value-Driven Healthcare in Action: A Four-Pronged Approach to Meet Consumer Transparency, Quality and Access Demands.

Click here to listen to comments from Austin, Davis, Lewis and Xistris online.

Strategies to Increase Primary Care Access, Use and Coordination

May 7th, 2007 by Melanie Matthews

Involving physicians and nurses in an initiative that teaches patients how to manage their own care may initially increase the demand on an already overtaxed primary care system, says Christopher Wise, administrative director of the Medical Management Center at the University of Michigan (U-M) Health System. But ultimately, the patient who better understands the intricacies of their disease and available care alternatives will actually have fewer reasons to access primary care physicians, he adds. In U-M’s model, he explains, social workers and nurses who know the university’s health services best function as health navigators, helping the chronically ill find their way through the system. For optimum efficiency and results, the patient’s self-management must be linked to a broader aspect of the physician’s office and the medical home it provides.

Margaret Brennan, administrator for the Primary Care Access Network with Orange County Government, Maureen Kersmarki, board chair of the Primary Care Access Network for Florida Hospital along with Wise, described how their respective organizations have created sustainable partnerships for increasing access to primary care during a May 16, 2007 audio conference, Strategies to Increase Primary Care Access, Use and Coordination.

Click here to listen to Wise’s comments.