Can’t We Do Something to Better Coordinate Care?
There really is a solution to the age-old problem of uncoordinated health care — the kind of care that bounces you from place to place for various procedures and tests. Or leaves you wondering why your doctor never seems to know what medications you’re on.
The answer is the team-based approach to care. It’s a model where a doctor — typically your primary care physician — heads the team and coordinates with specialists, physician assistants, nurses and care managers to make sure you get the right care at the right time.
The model promises to make things easier for patients and cut down on at least a portion of the estimated $130 billion in health care spending wasted on inefficiently delivered care.
Where the Team is Playing
North Carolina’s major health systems are making an effort to improve the coordination of care. Carolinas HealthCare System in Charlotte, for example, has a Center for Advanced Practice to train nurse practitioners, physician assistants and others to collaborate and coordinate with physicians. It’s one of the first such centers in the nation established within a large health system.
Better care coordination was one of the goals last year when BCBSNC teamed up with CHS to offer a new product in the nine-county Charlotte area. The popular concept now is expanding to the greater Triangle region, as BCBSNC has announced a partnership with Duke Medicine and WakeMed to offer a new Blue LocalSM product beginning with this fall’s enrollment period for 2016 health coverage.
In both Charlotte and the Triangle, Blue Local health plans are built around a limited network of providers and the better-coordinated care that the network offers. As a result, our Blue Local plans offer an average premium savings of about 15 percent compared to the company’s traditional broad-network plans.
What Took So Long?
So why is health care just now coming around to the team approach?
Essentially, it took decades for our current system — and all its warts — to evolve to what it is today. Poor communication among providers is certainly a part of uncoordinated health care. Another reason is the medical profession’s history of developing specialized areas of practice.
The impact of uncoordinated care is huge. A recent study in the American Journal of Managed Care found patients of the most fragmented physician practices had medical bills that were on average $4,542 higher than the best-coordinated physicians.
Better-coordinated care — the team approach — is a big component of the transition to value-based care, which is picking up steam and showing results.
Another method of improving care coordination is through what’s known as an Accountable Care Organization. ACOs are arrangements between doctors, hospitals and health plans that share financial responsibility for providing coordinated, high-quality care.
In keeping with efforts to better coordinate care, BCBSNC is a part of three active ACOs that encourage collaboration. Each features incentives for the hospital and physicians to efficiently manage care for BCBSNC customers. The ACOs are in Raleigh, Wilmington and the Triad.
The team-based approach to care is here to stay as more health care professionals and organizations embrace the concept.
“It ensures each patient gets the right care at the right time from the right health professional,” Robert Wergin, MD, president of the American Academy of Family Physicians, said during a recent Washington panel discussion set up by the Institute of Medicine.