More than one in two Americans cope with a chronic disease, such as diabetes, hypertension, asthma and heart disease. And 75 million Americans have two or more of these ongoing and often incurable conditions. The costs of treating chronic diseases are enormous—more than $2 trillion annually—and chronically ill patients often struggle with fragmented care.
Beyond the countless initiatives aimed at containing costs and improving health outcomes for those with chronic diseases, what simple steps can medical practices take to improve the care experience for their complex, high-needs patients?
To find out, I talked to Laurie Morgan, a senior consultant and partner at Capko & Morgan who advises medical practices on operational excellence, revenue capture and the effective use of technology.
Maureen: When it comes to improving the patient experience for those with chronic diseases, where should practices begin?
Laurie: My first recommendation would be to focus more on the human touch. These patients are often scared and overwhelmed, they’re in pain and they have to make frequent trips to the doctor.
Prioritizing a more personal touch isn’t easy, especially in practices that treat a large number of chronically ill patients. Such practices are typically very busy and their staff often doesn’t have the bandwidth to pay close attention and answer patients’ questions. Luckily, there are technology solutions now that can remove some administrative burdens and give staff more time to make patients feel welcome and address their concerns.
But even simple things, such as greeting a patient who comes in frequently by name or listening intently to a patient’s questions, go a long way.
Maureen: What are some other steps practices can take?
Laurie: It sounds so basic, but I advise my clients to really think about what patients with these conditions need when they come in for a visit. In a rheumatology practice, for instance, patients with mobility issues may bring one or two family members to each visit. Are there enough chairs to account for that? Are the restrooms easily accessible for people using walkers or wheelchairs? These are small considerations that can really improve the experience for these patients.
If a patient frequently comes in with the same family member, it’s also important to make sure that family member is informed and engaged and has access to the patient’s medical record, if that’s what the patient wants.
Additionally, drugs for chronic conditions can be a huge cost, but payment assistance programs are available, so it’s a good idea to have someone in the practice tasked with helping patients sign up. Insurance plans are also much pickier about preauthorization these days, so it really helps to have a staff member who is on top of that. These patients are in pain and an insurance issue can weigh much more heavily on them than it would on a healthy patient.
Maureen: What advice do you have for practices that want to go even further in their efforts?
One of the things we usually recommend to our clients is to consider scheduling group visits for patients with chronic diseases. It allows a number of patients with the same illness to be seen at once—usually after the office is closed, which is convenient for patients who work full-time. Group visits aren’t therapy sessions, but oftentimes patients will chime in with support and advice for each other.
Group visits are not for everyone, obviously. Patients must agree to have their medical information revealed, and some aren’t comfortable with that. Some doctors aren’t either. But group visits do give chronically ill patients another way to access care and to have the support of others with their same condition. Group visits also give practices another source of revenue.
In some cases, it may be good for practices to consider participating in Medicare’s Chronic Care Management Services program, which reimburses for non-face-to-face care coordination services provided to Medicare beneficiaries with multiple chronic conditions. The code requires telephone outreach to each patient for at least 20 minutes once a month.
Many practices have pushed this option aside because they think it will be too much work or because they think they will have add staff to do the work. But I think it can be a real advantage when it comes to bringing more of the human touch to your practice and improving care—and you get paid for doing it.
