Ambulatory care is broken. Despite remarkable advances in clinical care and emerging information technology, financial and operational pressures often force health systems to sacrifice service for volume with little to show for the effort as the bottom line still suffers. Amidst all of this, the experience for both the patient and clinician sadly continues to deteriorate.
The root cause is access to care. Patients are waiting longer than ever for an appointment. It requires an average of twenty-four days to see a physician. Even with those twenty-four days, no more is being done to gather medical records, execute necessary tests or labs, or prepare the patient. Twenty-four days for a disease to progress, anxiety to mount, and alternate care to be sought. A total loss.
To solve the access problem, providers are pressured to increase capacity to manage more volume. Seeing more patients and working longer hours is the new normal. Another strategy is to shorten appointment lengths to theoretically increase provider productivity, leaving less time to prepare, less time with the patient, and less time to document. Unfortunately, this problem will get worse before it gets better as healthcare remains primarily focused on fee for service work to fund their business.
Given the above, it is no surprise that 54% of practicing physicians’ report burnout, up from 28% in 2011. This growing physician shortage complicates the issue further compromising capacity and exacerbating an already unfortunate cycle.
Achieving desirable clinical outcomes and excellent visit experience is challenging, at best, in this environment.
This access quandary puts health systems in a near impossible position.
They must juggle a tough financial environment while serving their mission and supporting their clinical staff. Payment models are indeed changing, but at an unpredictable pace. As a result, systems don’t know what to expect and feel the pressure to maintain market share and margins in their fee for services business. Meanwhile, growing value-based care business lines prioritize achieving incentives for managing care outside of the hospital setting, also increasing demand for ambulatory visits. Pouring fuel on the fire, inpatient margins are down, applying financial pressure across the enterprise.
The underlying message being sent to every health system and clinician? DO MORE with less. Unlock access AND preserve margin. See patients faster AND prevent leakage. Grow market share AND close every care gap.
Heath systems attack these challenges in many ways. They are seeking more volume, higher clinical productivity, growth in market share, a larger geographic footprint, acquisition of more practices, and leaner operations. Doing more of all of this may help some, but is not enough.
Successful organizations must reduce loss and improve service to succeed during concurrent fee for-service and value-based payment models. They must do the following at scale:
- Help patients understand what to expect
- Intelligently serve patients across multi-modal resources
- Efficiently prepare patients and providers for every visit
- Reduce patient and provider time wasted in empty or unnecessary visits
- Create a valuable patient and provider experience
Carrie Kozlowski and I launched Upfront Healthcare Services last year to make every visit valuable for patients AND providers. We believe this optimization should occur on a visit-by-visit basis and that technology is the only way to do this at scale. We use our innovative Visit Value Technology and machine learning to identify and prioritize opportunities to:
- Improve the team based approach and deliver top of license care
- Prepare for visits in advance and eliminate unnecessary re-visits or no shows
- Strategically identify and schedule necessary high value visits
We then use our Visit Value Technology platform to monitor future appointments with those priorities in mind and deploy Upfront Optimization Services to intervene before the visit, with goal of benefitting the patient, the provider, and the health system. Benefits include:
- Return on Investment of 3X
- Improve the patient experience and patient access
- Enable clinicians to work at the top of their license and reduce burnout
- Earn value based incentives
- Grow health system margins
- Ensure optimal team-based care
Our team’s past experiences and deep knowledge of the problem combined with our drive to fix it for patients and providers powers Upfront. We’ve taken those lessons to heart at Upfront as guiding principles:
- Upfront partners with clients to solve the problems, not just identify them
- Upfront works for all patients and providers. It is not a “population” or “payment” specific solution
- Upfront leverages existing client infrastructure wherever possible. We are not another place to log in to for patients or clinicians
At Upfront, we are on a mission to make all visits valuable across the ambulatory enterprise. Click here to learn more about Upfront Healthcare.