NYAPRS Note: Representatives across the healthcare sector met recently and highlighted the challenges and necessity of making alliances with primary care providers. A leader in this effort who’s referenced below is Virna Little, the Institute for Family Health’s Senior Vice President for psychosocial services and community affairs. Virna gave an excellent presentation at last fall’s NYAPRS Conference and a number of us huddled together recently with her at the Behavioral Health Summit at last month’s Community Healthcare Association of NYS conference.
Virna will be the featured speaker for our next NYAPRS’ Medicaid Redesign Learning Collaborative webinar on December 2nd. Stay tuned for more details!
With Care Coordination, Primary Care Providers Need A Push
Crain’s Health Pulse November 3, 2015
New York is moving to initiatives that rely heavily on coordinated patient care. The Primary Care Development Corp. and 1199 SEIU held a conference last week on the concept, which also was the subject of their recent report.
Panelists discussed some of the challenges of implementing care coordination, and tapped some in-the-trenches advice on how to do a better job of it.
New York has experience in health homes and ACOs, of course, but there still is some question over what care coordination is.
“Care management and care coordination can be two different things,” said Dr. Karen Nelson, senior vice president of integrated delivery systems at Maimonides Medical Center. Understanding them is important, however, because they are essential to the value-based payments model.
“There is no way to do value-based work until we break from fee-for-service,” said Nelson.
As essential as it is, care management is tricky to implement.
Virna Little, a senior vice president at the Institute for Family Health, said there must be a “warm handoff, so someone is able to introduce members of the team,” including people in the field.
Care management is team-based, but physicians in particular aren’t accustomed to collaboration, the panelists agreed.
“Care managers are trying to bust their way into a medical practice” to get the attention of primary care providers, said Nelson. Managers are often from outside agencies and aren’t accepted by doctors.
And talking about a care plan isn’t intuitive for doctors.
“We’re now all ‘huddling,’ Little said, prompting some laughs from the audience. One challenge is “prioritizing who we talk about when we huddle. Care managers have to set that agenda.”
There is a reason primary care providers aren’t always on board. Nelson noted they are not paid to huddle or deal with social-services issues that affect their patients. Time spent on that translates to lost revenue.
That’s where the carrot-and-stick model has a role. Care managers can learn to talk the language of primary care and pass on information to clinicians—the carrot—that can help them with their patients….