How can we help doctors help patients?
This seemingly simple question cuts to the heart of healthcare. Physicians are looking for novel solutions to streamline and improve care delivery in our ever-changing industry. The potential for more risk-based reimbursement in value-based programs is on the horizon. This exciting evolution has spurred many doctors — whether in private practice or other arrangements — to seek a partner that can help them adapt and focus on what matters most: caring for patients.
However, there are many complex barriers that face providers today. A study from Medical Economics grouped these challenges into three broad categories:
- Administrative burdens and paperwork
- Appropriate compensation for patient care
- Physician burnout and autonomy
Physician enablement aims to equip providers with the tools, talent, and technology to overcome these obstacles.
When evaluating a potential partnership with a physician enablement organization, practices should consider these six key components.
Healthcare technology is increasingly powerful and prevalent. Physician enablement organizations should aim to implement an interoperable, end-to-end technology platform that streamlines physician workflows, optimizes performance, and frees up time for patient interactions by significantly reducing complex, confusing and/or time-consuming administrative tasks.
Artificial intelligence (AI) built into the electronic health record (EHR) can reduce clinician burnout. Automated patient outreach can help close care gaps to help improve patient health outcomes as well as increasing reimbursements. Virtual scribe software can result in cost savings while allowing providers to focus more time and attention on patient engagement. Smart EHR templates and predictive analytics can also help doctors address and satisfy key metrics to bolster reimbursements in value-based contracts.
Technology can both improve the patient experience and give patients more control over their healthcare and patients are eager to use technology for their care. One survey found that nearly half of patients “wish the digital healthcare experience was smoother and more intuitive.” Telehealth can increase access and avoid unnecessary emergency room visits. Patient portals can give patients more control over their care by allowing them to easily message their providers, pay bills, refill prescriptions, and more. Secure, convenient mobile apps can increase engagement, improve health outcomes, and reduce costs.
Enabling physicians goes beyond just implementing technology applications. Integration and interoperability to create an end-to-end technology solution set are critical to maximizing effectiveness and efficiency. Well-integrated and fully interoperable technologies and data access can help increase care coordination, lower costs, and improve the well-being of providers and patients alike. Moreover, physician-enablement groups should elevate physicians’ perspectives, factoring their expertise and experience into clinical informatics to design digital tools that work for — not against — providers.
Many independent physicians today struggle financially. The COVID-19 pandemic has further exacerbated the problem. As Rebecca Pifer reported for Healthcare Dive: “[T]he competition for scarce supplies and federal aid paired with a catastrophic plummet in patient visits early in the year left independent primary care practices — many already operating on razor-thin margins — wheezing.” Data from the American Medical Association shows that less than half of doctors work at a physician-owned practice. Financial instability and uncertainty lead some doctors to leave private practice. Although many physicians are interested in value-based contracts, 97 percent still rely primarily on fee-for-service reimbursement, according to Deloitte.
It is critical that physician enablement be powerful and cost-effective. Physician groups can grow practice revenue by optimizing reimbursements and lowering expenses. Supporting performance in value-based contracts can help reward providers for delivering high-quality care. Similarly, tools to reduce administrative burden may allow physicians to see more patients, thereby increasing fee-for-service revenue.
Management services organization (MSOs) can also enable physicians by reducing direct costs. These organizations bundle, offload, and support necessary services, such as payer contracting, revenue cycle management, care value reporting, performance management, and more. An MSO’s scale and specialization can also lead to group purchasing discounts, further reducing practice expenses. Reducing administrative work and stabilizing finances can help care teams devote more time, energy, and resources to patients, not paperwork.
#3: Physician Variety
Enabling physicians means enabling all physicians — primary care and specialty, independent and employed. All providers play a pivotal role in the healthcare landscape. As such, physician enablement organizations should seek to offer tools and resources that benefit all partners. That doesn’t mean taking a “one size fits all” approach. Rather, a high-performance model should include customizations while aligning around shared values: forward-looking, evidence-based, patient-centric, and more.
Sophisticated physician enablement should both promote autonomy and encourage growth for all partners. Doctors, including those employed by hospitals or health systems, want autonomy in clinical decision-making to serve the unique needs of their diverse patients.
Additionally, physician enablement organizations should foster a growth mindset. Transitioning to value-based care is a difficult path, one lined with advances and setbacks. That’s why it’s essential that physician enablement promotes education and learning wrapped with a rewarding experience for improving clinical outcomes and patient experience. Appropriate governance of physician enablement organizations is key to driving both physician autonomy and growth. Physician-led governance fosters collaboration between doctors, opens opportunities to exchange best practices and feedback, cultivates leadership, and elevates the clinical voice, giving doctors a platform to make meaningful changes in the communities they serve.
Doctors want the freedom to care for any patient regardless of their payer. This is especially critical to value-based care. Physicians need to be able to grow their base of patient lives attributed to multiple risk-based reimbursement models in value-based care programs. Therefore, physician enablement organizations should seek to increase access for all patient cohorts.
However, physicians must also be enabled with the tools, technology, and resources to engage a diverse patient cohort. For example, while some patients may prefer and be comfortable utilizing telehealth, others will inevitably opt for in-person visits. Patient portals can create a seamless self-service hub for digitally minded patients, but some patients prefer a phone call when scheduling an appointment or paying their bills. This consumerism in healthcare is continuing to rise, and physician enablement should strive to help doctors meet all patients where they are and how they want.
#5: Flexible Yet Replicable to Achieve Scale
Flexibility, replicability, and scalability are inextricably combined. These features work together to elevate physicians’ voices, effect change in their communities, and move their markets to value-based care.
When evaluating a potential physician enablement partner, look for a partner whose strategy is elegant yet hard for competitors to copy. Consider asking questions such as:
- How large is their physician base?
- How quickly is their physician base growing?
- How long does it take for a practice to implement the solutions?
- How does the group deploy technology and governance to organize and unite physicians while continuing to expand?
- How does the model fit the unique needs of the community?
- How does the organization leverage existing resources (e.g., patient panels)?
- If the organization serves other markets, how have these markets performed in value-based care initiatives, such as the Medicare Shared Savings Program (MSSP)?
Answering these key questions can help to measure an organization’s current state and growth potential.
#6: Multi-Decade Commitment
Physician enablement is not a once-and-done business. It must shift, evolve, adapt to fit the healthcare landscape and continually improve the experience of physicians. From Big Tech’s growing role to federal or legislative initiatives, the future of healthcare is uncertain in many respects. However, two critical elements you should look for in a forward-looking physician enablement company are operational excellence and an ongoing commitment to engagement.
Groups that pursue operational excellence are never satisfied with the status quo. They are flexible and adaptable, always seeking to refine their current capabilities and create new services. Whether forming new strategic collaborations or continuing to succeed in core functions, a powerful physician enablement organization ought to consistently explore and invent new solutions.
Moreover, enhancing provider well-being — financially and emotionally — is crucial to success. Even the most high-tech, cutting-edge, industry-leading solution will fail if physicians are disengaged. This principle informs the Quadruple Aim’s fourth tenet of “improving the work life of healthcare providers.” Research shows that greater patient engagement can meaningfully improve health outcomes. This same logic extends to the providers who care for them — by engaging providers, amplifying their voice, and supporting leadership, we can truly transform healthcare.