The pace in which we deal with change in the healthcare industry has reached warped speed. We have never had to be as flexible and as agile as we do right now!
Not only do Medicare Advantage Plans have to adjust to the pace of an ever-changing environment, but our provider partners are greatly impacted like never before.
Change has always brought about uneasiness and uncertainty, but change has also always brought about opportunities for growth and development - OGADs - as one of my mentors called them.
Now more than ever, the healthcare industry has a great opportunity to really become an integrated system that meets the healthcare needs of our members and affords them good quality of life in their latter years. Isn't that really what risk adjustment, STAR Ratings and Healthcare reform is all about ... healthcare for some, better healthcare for others?
It is an opportunity to look at and develop programs that not only assist members in becoming more aware of, and engaged in, the decisions that are being made about their health, but also empowers members to make very informed decisions in selecting who will provide their healthcare services.
The key to being successful in anything that we do is to have a strong foundation. The foundation is the starting point or ground work of anything. In healthcare, that foundation begins with our physicians.
It is more important than ever that we ensure our providers have the tools, resources and support that they need to treat their patients effectively (positive quality outcomes) and efficiently.
When risk adjustment began, data was collected but not shared with physicians. We now not only have an opportunity but also a great need to share this information.
Physicians need their patient's medical condition history in order to make informed decisions for their patients.
Providers come in contact daily with their patients, this contact, in many instances, is what forms the patients' perception of their healthcare.
As I have a great opportunity to visit and listen to our provider partners I have heard first hand to some of their challenges. In the current environment of changing technology, increased documentation requirements and yearly coding changes, the providers' main focus is still on providing their patients the best care possible. As an industry we must support, collaborate and encourage our providers. We need to remind them that what they do is important and very much appreciated. Lets not allow that message to get lost or diluted as we continue to go through change. The fact is, without our providers, there is no health care.
In summary: A few ways to support your provider partners:
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Set up some one on one time with providers and ask them what causes them the most pain, then do something about it if possible
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Create tools that are intuitive and can be viewed at a glance or accessed easily, yet provide important patient information to be used during a face to face visit
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Ask for their feedback and suggestions on information that is most important to them
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Bring them along as you implement an EMR system and consider their ideas
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Establish relationships with their office staff
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Attend Physician Meetings and keep them updated on current events
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Let them know you appreciate what they do
Kimberly D. Stone, Director of Medicare Revenue Management, Government Programs Administration, Presbyterian Healthcare Services
