The Silent Toll: Chronic Conditions and a Buckling Health Care System

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By Dr. Kayur Patel

As COVID-19 surges in communities across the country, the primary care system is buckling. Practitioners are fearful about transmission, patients are scared to keep their in-person appointment and medical systems are redirecting clinicians to emergency rooms or coronavirus test sites. Combined, these factors are preventing primary care doctors from seeing patients, resulting in a dramatic decrease in reimbursements from insurance companies. 

Strain on the Medical System

In a recent survey, 40% of primary care respondents reported needing to lay off or furlough clinicians and staff, and 25% have had to defer or skip clinician salaries. Worse yet, primary care practices are estimated to lose $67,774 in gross revenue per physician in 2020 (assuming telehealth reimbursement doesn’t revert to pre-COVID-19 levels). During a global pandemic, primary care is needed more than ever, but some practices won’t survive.

The Silent Toll on Patients

The CDC recently published new guidance showing that people with underlying medical conditions like diabetes or hypertension, women who are pregnant and older adults are at increased risk for severe illness from COVID-19. These same individuals are facing the aforementioned barriers to primary care and treatments, making them exponentially more vulnerable to the impact of the virus. For those with chronic disease, even if they do not contract COVID-19, the backslide that can happen when a condition is not managed can be just as dangerous. This is especially true for disenfranchised communities that have historically faced obstacles to health care. 

Transforming Outcomes

Enter advanced primary care. 

Taking the direct primary care model one step further, advanced primary care practitioners partner with patients to help them live healthier lives. With a low and comprehensive fixed fee and a relationships-first, data-driven approach, the advanced primary care model uniquely prepares organizations on the front lines, informing their efforts to effectively respond to the ongoing coronavirus crisis and continue meeting the needs of patients.

Through proactive communication with patients about helpful resources and the option for virtual visits, providers are seeing significant success in their commitment to continued engagement with patients. Leveraging an innovative approach to data analytics, Proactive MD, a national leader in advanced primary care, identified two categories of patients in most need of outreach:

  1. Chronic — Patients at high risk for complications related to COVID-19.
  2. Crisis — Patients who have historically needed increased attention from providers related to chronic illness, mental health or addiction.

Using the organization’s proprietary algorithms, Proactive MD identified 25% of its patients as members of these two categories, and similar numbers can be expected for patient populations across the nation. Using these figures, health care organizations can begin campaigns to personally connect with these patients, whether over the phone or via a telemedicine appointment, continuing to engage them daily with apps, surveys and check-ins. And because these care providers prioritize the provider-patient relationship, their proactive, relationship-first model laid the groundwork for continuity of care.

A good provider-patient relationship fosters better communication, which drives improved health and wellness. Since patients of primary care clinics like Proactive MD have developed strong personal relationships with their clinical care teams, they are essentially able to jump in where they left off — even if they’re using a new channel to communicate.

From there, patient advocates work to assist patients in getting access to prescriptions, medical supplies, food, financial assistance, mental health programs and workforce navigation. Many vulnerable patients are reaching out to community organizations to have their basic needs met, and their efforts are amplified when dedicated patient advocates intervene on their behalf to ensure they receive the resources and support they need as the COVID-19 outbreak continues.

What Healthcare Organizations Need to Do

Strain on the primary care system will continue, especially as patient outreach remains non-reimbursable. However, it is imperative that patients in these newly identified at-risk groups are engaged. Deploying telehealth solutions and leveraging population health data on the patient panel are starting points for preventing strain on the health care system, exacerbation of conditions and, ultimately, death. In the long term, we must change the economics of primary care in our country, moving towards value-based care models like advanced primary care.

About the Author:

As Proactive MD’s chief medical officer, Dr. Kayur Patel works to bring alignment between employers, patients and physicians, ensuring the organization’s operational values are upheld: to improve health outcomes for patients, distribute medical resources more effectively and reduce employers’ overall healthcare expenditures.

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