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Physician Leaders Identify How Health Care Delivery Should Change
By Phillip Oravetz, M.D.
In a recent series of interviews conducted by the Council of Accountable Physician Practices (CAPP), physician leaders of America’s leading medical groups and health systems identified the important learnings from COVID-19 that should drive future changes in the overall health care system.
CAPP includes more than 30 large, integrated medical groups representing more than 85,000 physicians who are on the front lines of the pandemic. Their consensus is that the investments they made in telehealth, population health, physician leadership, and coordinated care to improve care delivery paid off in the COVID-19 crisis and should be implemented across the entire health care system.
Because these innovations were already in place, integrated medical groups were able to quickly transition the vast majority of patient visits from in-person to virtual, to remotely track and manage high-risk patients, and to leverage their existing team-based cultures to maintain continuity of care during the pandemic. In short, the “systems” approach to delivering medical care was the optimal approach in this crisis.
The CAPP physician leaders cited six major initiatives that should be encouraged to shape the American health care system post-COVID.
- Accelerate the Transition to Pay for Value. Instead of maintaining the current fee-for-service method. When providers are paid for outcomes, they can organize care for the benefit of their patients. When physicians are motivated to provide the right care and not more care, , they rapidly innovate to find the most efficient means of caring for patients – methods that improve care, enhance the patient experience, and are more effective at reducing waste and unnecessary services than care provided in a more fragmented system.
- Remote Care Is Here to Stay. Remote patient visits, by video or telephone, brought medical care to patients that was safe for them and their providers. Both physicians and patients are now accustomed to, and highly satisfied with, this care delivery method. Telehealth has a new value proposition beyond convenience; it solves many of the access issues that exist due to distance, shortage of health care providers and other barriers. The waivers initiated during the pandemic to pay for remote visits should become permanent payment policies.
- Health Care Is Moving Home. The lack of available beds during the pandemic has forced the health care system to think about alternative ways to care for people. Treatment at home – even hospital care in the home – can be safer, more convenient, less expensive, and more desirable for many patients. Those with chronic illnesses can use home-monitoring equipment to keep the care team aware of their condition. These ideas should be further pursued and supported.
- Primary Care and Prevention Require Mandatory Investments. The primary care physician is the quarterback of the patient’s care team. Yet many practices lack the financial means to develop the infrastructure needed to effectively coordinate with other providers and hospitals. They struggle to provide the preventive services and the care coordination that will help patients stay healthy. In addition, many physician practices experienced significant financial losses during the pandemic, when their patients were afraid to go to their offices. Primary care physicians can benefit from the support of larger integrated groups for the connection and infrastructure they need today, while better models of care and payment will help them deliver proactive, preventive care and stay financially solvent.
- Stakeholder Collaboration to Remedy Health Care Disparities. Policymakers, healthcare providers and purchasers must collaborate to address health disparities, which have been highlighted again by the pandemic. Minorities and low-income workers are disproportionately affected by COVID-19, as a result of many factors such as lack of access to regular health care, underemployment, and insecure housing, food, and transportation. The ravages of the pandemic are a wake-up call. The country must embrace a mandate to fix societal and economic conditions that lead to poor health and higher risk for certain groups of Americans.
- Bring Physician Leaders to the Table. Who better to help design America’s new health care delivery system than the accountable physician leaders who provide that care? These doctors should be involved in the planning and design of the next evolution of American health care. They are the experienced engineers of care delivery, and advocates who will make sure that the focus always remains on the patient.
If the country’s goal is to ensure a healthy America, the physician leaders call on policymakers, payers, and health care leaders to take action to quickly initiate these changes.
For more information, read “COVID-19 Lessons: A Path to a Better Healthcare System”.
Phillip Oravetz, M.D., is a board member of the Council of Accountable Physician Practices, and Chief Population Health Officer at Ochsner Health System in Louisiana.