As healthcare continues its slow but steady shift to a value-based landscape, good care coordination is becoming crucial for physician practices to thrive and for patients to get the best care. To coordinate optimal care, primary care physicians, who are often defined as “the quarterback of healthcare,” need to address common gaps in care and recognize the importance of their role.
The primary care physician’s role can’t be stressed highly enough, according to Clive Fields, MD, chief medical officer and co-founder of VillageMD, a healthcare management company that supports primary care physicians transitioning to value-based care in Chicago, Ill.
Fields says primary care physicians play such a crucial role in healthcare outcomes, that research shows when you add just one more such physician to a population of ten thousand, it results in a 5.5 percent decrease in inpatient admissions, an 11 percent decrease in emergency department utilization and a 7.2 percent decrease in the number of surgeries performed.
He says that employers and payers are recognizing that the most important way to drive economic and clinical value in healthcare is a long-term relationship with a primary care doctor.
However, he makes clear, “Any physician who thinks he can manage a patient by himself without a team is grossly misled,” he says. “Fragmentation of care is the source of all evil.”
“When patients are touching multiple providers with poor care coordination, you get a less than optimal result,” Fields adds.
The value of care coordinators
It’s important, Fields stresses, for physicians to bring a coordinated care manager of some kind on board, particularly for more complex patient populations, to make sure there are no gaps in care.
“[Care coordinators] understand the healthcare ecosystem, they understand the limitations of people’s insurance and what a patient’s goals are,” Fields says.
For example, among a senior or chronic care population, he says, his primary care teams includes transitional care nurses, chronic care managers, diabetes educators and social workers.
Leesa L. Bain, RN, CSN, MHA, vice president of care coordination, quality management and transitions to community living for Cardinal Health Care in Charlotte, N.C. agrees that physicians need care coordinators and should consider having one in-house. “Physicians are experts in diagnosis and determining what treatment should be. We need physicians to focus on what they’re experts in,” Bain says.