The Waiting Game and High Value Care

In the old days, we mainly worried about physician practice access because of the impact on patient satisfaction. This provocative article in this week's NEJM from the Geisinger experience argues that long waits for specialty care are financially incentivized by volume-driven fee-for-service. It also argues that long waits for specialty care (and I'd argue primary care) are financially expensive in value risk-based care because they delay needed care and drive it to higher cost settings, especially hospital admissions. I agree with them: one of the best ways to improve health outcomes and decrease total cost of care is to provide excellent care access, both primary and specialty, and to make sure there is an easy way to access at least a live person 24/7. Lacking that, patients often feel like they have no alternative but to go to the ED. What do you think? Here's the link: https://www.nejm.org/doi/full/10.1056/NEJMp1704478?query=featured_home


Terry Alice McInnis MD, MBA, MPH

Board Member and Strategic Advisor| Angel Investor| Physician Executive| Pharmaceuticals and Diagnostics| Oncology and Vaccines| Value-based Contracts| National Speaker

7 年

That is why I believe a key answer is clinical pharmacist services in collaborative care with physicians. This is not a dispensing drug role. Think of the role that pharmacists play on the inpatient side and translate that to seeing patients directly in tram based card in the clinic and working to change the medications to optimize outcomes . That is an answer to our handwringing about inadequate access,

Andrew Weniger ??

General Manager at Firstview LLC

7 年

Yes! Access measured from initiation to interaction is critical, and access to follow-up care after the interaction may be even more important. Thanks Al.

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