The patient-centered health care in Chatham is proving effective. As President-elect Donald Trump shapes an agenda for the following four years, he has pledged to supplant former President Barack Obama's signature Affordable Care Act, which has become prohibitively exorbitant for many.
Trump already pointed out that his administration's goal is to make a patient-centered health care structure that focuses on promoting excellence and affordability according to an article on Savannah Morning News.
The mention of patient-focused health services offers a glimpse into something doctors, healing facilities and insurance agencies have now been taking a shot at and refining for a long while.
Blue Cross and Blue Shield (BSBC) of Georgia reported encouraging outcomes a month ago from primary care specialists in Savannah who have participated in the organization's value-based, patient-centered program throughout the previous three years.
On July 2013, BCBS of Georgia's Enhanced Personal Health Care begun and now covered more than 200,000 patients with more than 1,200 doctors coordinating.
How does it work?
Partaking practices which are mostly primary care workplaces, get direct care coordination payments monthly from the insurance agency to offset the cost of the extra work required to adopt a patient-focused care model and effectively manage care. They get data and insights too, which obtains from insurance agency information that helps them manage patient's health better as cited on Help Connection.
Those practices that succeed in sustaining or enhancing the quality of care and hit their cost-of-care targets earn rewards in the form of a share in the savings they deliver toward the end of a 12-month estimation period.
Resources intended to guarantee better patient care incorporate information that enables providers to target people with chronic conditions or gaps in care like medicines that haven't been filled or missed medical examinations and a system to flag members at risk for readmission to the healing center. Apparently, the plan benefits more than just practices and insurance agencies.
The results delivered by the program which was statewide in 2014 stated that participating primary care doctors offered a 2% higher rate of care for diabetic patients, including screening for kidney infections, monitoring blood sugars, helping to prevent amputation and other difficulties of living with diabetes; a 3.5% better rate of cervical and breast tumor screenings; and a 4.5% increase in patients taking their cholesterol, blood pressure and diabetes medications as recommended.
Locally, participating practices including South Coast Health, Memorial Health, University Physicians, St. Joseph's/Candler Medical Group, Pediatric Associates of Savannah and Family Health Care Center in Statesboro have shown promising changes and helped to enhance quality.
WHAT IT DOES
According to Angela Kaylor, "Healthcare is developing." "Everybody's looking at quality measures and information. And we are becoming more centered around keeping people healthy. Becoming more of a proactive and not reactive practice", she added.
She said, Memorial is working with various insurance agencies, although BCBS was the first to present a patient-centered care program. Its goal is to lessen costs while enhancing quality, patient outcomes, and satisfaction.
She also stated that when people are healthier, their health care expenses will lessen. Dr. Ben Spitalnick, a Savannah pediatrician, concurred.
IMPROVING COMMUNICATIONS
Dr. Thad Riley possesses Family Health Care Center in Statesboro.
According to him, they requested to get involved in the program as soon as possible. The software that distinguishes what we call "hot spotters" amazes him. It helps them to see who are setting off to the emergency room when perhaps they could have kept them out of the ER. Or, if they go into the doctor's facility, it lets them know when they released so they can set a follow-up visit and keep them from going back.
Riley's practice also has adopted another program that is centering in on the primary markers of chronic disease management, collaborating and sharing information technology to enhance care, avoid duplication of services and decrease costs.
A therapeutic office or facility where a group of health professionals work together and cooperate to give a new, expanded type of care to patients is a "medicinal home," according to the National Committee for Quality Assurance.
ST. JOSEPH'S/ CANDLER ON BOARD
It's an idea that St. Josephs/Candler Medical Group has to adopt, with its Eisenhower practice obtaining NCQA Patient-Centered Medical Home acknowledgment for using "evidence-based, patient-focused processes that concentrate on highly coordinated care and long‐term, participating connections."
Research shows that medical homes can prompt to higher quality and lower costs and can enhance patient and provider reported an experience of care according to Katie Gingrich, quality chief for St. Joseph's/Candler Medical Group.
"We use electronic medical records to ease your care so that you don't have to repeat a similar data with every health care provider. The goal is to make sure that everybody agrees about your care," Gingrich said.
St. Joseph's/Candler also partakes in the BCBS Enhanced Personal Health Care program. It was the Blue Cross Blue Shield that was one of the first commercial payers to move toward quality-based care tailored to the patient's medical needs according to her.
"BCBS remains by far the most in-depth program," fresh added.
STAYING INDEPENDENT
Riley said independent doctors need the resources the insurance agencies offer.
"It's impossible for a group of independent doctors to keep up all of this on their own. Programs like Blue Cross are critical in helping independent doctors stay independent. That's a part of health care we would prefer not to lose", he stated.
