Posts Tagged ‘physician engagement’

Patient Engagement Prerequisite: School Staff in Patient Activation, Health Literacy

October 19th, 2017 by Patricia Donovan

YNHHS embedded care coordinationEven after multiple years of patient engagement education, awareness training and related programming for its clinicians, PinnacleHealth Systems knew those efforts needed to continue if they were to move forward with new interventions. Here, Kathryn Shradley, director of population health, PinnacleHealth System, describes two key focus areas for clinician education.

We wanted to level-set on the definitions of patient activation and health literacy and what these terms meant to the organization and to the teams within. In full transparency, I want to be very clear: I believe initiatives for health literacy, patient engagement, patient education and population health will be on our task list for as long as I’m employed, and that’s okay.

We spent a lot of time educating front-line clinicians on health literacy, understanding who was using the Patient Activation Measure® (PAM®) and tools and attempting to broaden the language used around the health system. One of our initial goals was simply to have the words ‘health literacy’ be recognized and understood throughout the system. This is certainly still something we work on daily as a core piece of all of our engagement strategies. I’m happy to say that we have made progress.

One of the ways we obtained buy-in for our patient engagement strategy was to talk about the financial bottom line of low levels of patient activation and low levels of patient health literacy. We demonstrated to our executive teams, directors and managers that no matter where they were building an initiative and what they were building, if they didn’t include an engagement strategy in their product or service line, they were likely to experience difficulty—a difficulty that could otherwise be mitigated if we addressed some of these issues in their programs.

Source: Dual Approach to Patient Engagement: Activating High Utilizers and Coaching Clinicians

patient engagement

Dual Approach to Patient Engagement: Activating High Utilizers and Coaching Clinicians describes PinnacleHealth’s two-pronged strategy for prioritizing patient engagement among its clinicians and patient population, tactics that elevated key quality and clinical metrics in the process.

6 Metrics to Engage Physicians in Value-Based Payments

May 22nd, 2014 by Cheryl Miller

As incentive models change for physicians and their practices along with the industry’s move to value-based care, it is key to engage them in the evolving process, says Cynthia Kilroy, senior vice president of provider strategy and business development at Optum. After you find a common value-based vision, you need to spend time with the physicians discussing what value-based care is, including how it is going to impact them, and what it means for their practice, among other things.

When you think about engaging physicians, which is how we typically roll this out across organizations, six key performance metric steps are needed to move this along. This is not something that happens in a couple of months. It takes one to three years to move a compensation model to a large 20 to 25 percent of incentives.

After you find the common value-based vision, you need to spend time with the physicians discussing what value-based care is, including how it is going to impact them, what it means for their practice, how we support them, etc.

Once you have alignment with that, the finding and designing of incentive metrics has to be done by the physicians. This cannot be done in a vacuum. It needs to be physicians from all different types of practices or specialties and different locations within the organizations that you look at. What are the incentives I want to measure?

Then you publish the incentives and blind those incentives so that physicians can digest and challenge them. Something may need to be modified. Therefore, you should give that time and feedback. Once you have that feedback, you can unblind it. Organizations find unblinded incentives to be a very powerful tool, but you need to make sure that you have the alignment and agreement and that people believe in the metrics, because if you put metrics out that are incorrect or not of value, you have lost the opportunity to change that behavior.

Then you create a shadow incentive reimbursement model, letting physicians know where and how it is going to impact them, allowing them to potentially change how they are practicing or leveraging the care team more.

Finally, you implement the incentive compensation model. There are two phases. One is to meet the minimum, which is typically the first way that the incentives compensation is executed. The next is a rating factor around the quartile, and that is something that takes time as well.

Next is the analytics platform. When finding, designing and publishing the incentive metrics, you build them, share them, get feedback and then approve the metrics. You need an analytic platform to understand and measure these new metrics that we are looking at.

Excerpted from 6 Value-Based Physician Reimbursement Models: Action Plans for Alignment, Analytics and Profitability.

How to Engage Specialists in the Patient-Centered Medical Home

April 1st, 2014 by Patricia Donovan

Primary care's relationship with specialists will influence quality and reimbursement.


Florida Blue’s primary care focused pay-for-performance program transitioned in 2012 into a statewide patient-centered medical home (PCMH) initiative. Here, Barbara Haasis, RN, CCRN, senior clinical lead for quality reward and recognition programs at Florida Blue, describes the role of primary care in engaging specialists in the PCMH program.

Engagement of specialists happens through the primary care physician (PCP). The PCP will be judged on the total cost of care, and his percentage of the shared savings is based on working with specialists that are efficient, and that report back to him or her, so that they are aware of what is going on. That is the development between the PCP and the specialist. They have to go to a specialist in the network, but we are not specifying who.

There is a huge incentive for the PCP, because when we look at a member’s total cost of care, we are looking at inpatient/outpatient, specialty, primary, lab, x-ray, total cost of care—it is everything. If there are two specialists, and one orders every test under the sun, whether it is needed or not, and the other goes into the ER to see the member and takes care of them efficiently and effectively, that primary care doctor is going to change his referral pattern to go to the more efficient. That is the incentive.

We are setting up other arrangements with specialists that will marry up to the PCMH. For example, we may do some kind of preferred cardiology network in the Orlando area into which the PCPs will probably refer. We cannot do that here. We have contractual language with many of our facilities and physicians that prevent us from doing any steerage.

It is up to the physicians to work through relationships to find the most effective for their practice.

Excerpted from: New Models in the Patient-Centered Medical Home: Incentives, Infrastructure and IT to Support Accountable Care