The always evolving Medicaid landscape as well as the implementation of healthcare legislation such as the Affordable Care Act are changing the healthcare continuum at all levels. Among these changes are more outcome-driven and preventative care mandates, vastly changing fee structures and incentives for providers, increased patient loads, and even thinner financial margins.
The implementation of patient-centered medical home (PCMH) care models and the Accountable Care Organization (ACO) are two growing trends meant to increase efficiency among providers while improving patient outcomes. The medical answering service must play a key role among the healthcare players in these organizations as their effectiveness hinges on improved patient/provider communication.
In the PCMH model of healthcare delivery, a team of providers including physicians, nurses, nutritionists, pharmacists, and social workers collaborate to meet a patient’s health care needs. The goal of this enhanced primary care delivery model is to achieve better access, coordination of care, prevention, quality, and safety within the primary care practice. At its center is the creation of a stronger partnership between the patient and primary care physician.
While the ACO is also based around a strong primary care core, it is made up of numerous primary care providers, practices, specialists, and hospitals in order to be able to control costs and improve health outcomes across the entire care continuum. Since they are designed to better manage the care for a greater population of people, ACOs are accountable for the cost and quality of care both within and outside of the primary care relationship.
In order to achieve their goals, both models rely on extended office hours and increased communication between providers and patients via email and telephone. The goal of which is to increase care coordination and enhance overall quality, while simultaneously reducing costs.
Individual healthcare providers are already taxed in terms of incoming patient communication. The medical answering service has been a major source of improved patient communication/satisfaction as well as provider flexibility in the prioritization of tasks in terms of staff. The advent of the PCMH and ACO models means that providers must find ways for a more coordinated approach in communication.
(1) Better Coordination of Care/Communication, Cost Savings among Providers
With cost savings as a cornerstone of these models, it becomes beneficial to look at a collective relationship with a single medical answering service in order to better coordinate patient-to-provider and provider-to-provider communication while lowering overall costs. This better serves the goal of coordinated care for patient populations by preventing provider care redundancies and eliminating potential treatment gaps.
These two areas have been historical challenges in patient populations where patients see several specialists and other healthcare providers in addition to their primary care physicians in order to treat and manage chronic illnesses. When hospitals are added to the equation, pre-admission and post-discharge medical care also is improved due to improved provider/patient communication via the support of the medical answering service.
(2) Regulatory Compliance
Another of the primary challenges to the PCMH and ACO models of patient care is the mandate of ensuring that patient information is protected in accordance with HIPAA regulations. Consequently, it becomes imperative for individual providers as well as those PCMH and ACO model providers to utilize a HIPAA-compliant medical answering service.
This ensures that confidential patient information is protected while enabling the healthcare providers to better share patient information. The medical answering services that meet these criteria are also fluent in the language and needs of patient and provider communication within the healthcare continuum. The growing non-English speaking patient population in the U.S. only heightens the need that providers belonging to these healthcare models have bilingual support via a medical answering service.
(3) Increased Inbound and Outbound Communication Opportunities that Serve Patient Wellbeing
By working with a medical answering service that meets these criteria, healthcare providers can more effectively direct patients to the appropriate care in a 24/7/365 cycle as it pertains to inbound communication from patients. In addition, outbound communication can also be enhanced by the medical answering service in terms of vital communication that affects healthcare outcomes as well as preventative care goals.
This vital outbound communication can include status check for post-discharge patients, medication/care protocol reminders and more. In addition, routine tasks such as appointment reminders, patient-centered health information, preventative care messages, and health program opportunities can be communicated via outbound communication efficiencies derived from a medical answering service.
In the new landscape of the healthcare continuum, improved outcomes, healthcare crisis prevention, and a more stable bottom line for providers all hinge on coordinated provider/patient and provider/provider communication. It is increasingly apparent that the medical answering service will play a huge part in helping the healthcare continuum deliver on those goals.