Recently, I was asked why there’s been a “permanent” drop in patient visits for some practices or providers. I was initially stumped by the question. After a little thought, I gave the same response I’ve given to so many questions in the past year: “We don’t know yet if that’s true.” Yet in Medscape’s annual Physician Compensation Report, 54% of doctors said that has been their experience.
I don’t believe patients are permanently abandoning their doctors, but if we want them to return, practices have to take the lead and reconnect.
As with so many parts of life, we’re still in the midst of a prolonged Groundhog Day. Some patients are sticking their heads out, peering around, and asking, “Is it safe out there? Or should I stay holed up for a little longer?” Some patients may not be so worried about safety, but their usual care schedule may have been disrupted, or the usual patterns of life that remind them to go in for a check-up may be missing. And some are struggling with insurance or job loss.
Practices need to proactively overcome the hurdles and convince patients that it’s not only safe to reengage with their providers but also critical they get overdue preventive care as soon as possible.
The second message is especially important when you look at the kinds of patient visits that were still below baseline in December of last year, like cardiology, pulmonology, and pediatrics (Commonwealth Fund). Ill patient visits were down, which is good news, but missing check-ups, check-ins, and tests is not. Preventive care has been improving but patients are certainly not caught up (Health Care Cost Institute). And we can’t overlook the fact that providers can be a mental health lifeline; the loss of that lifeline might be one reason overdose deaths were 20% higher over the past year (CDC).
We missed an opportunity to reengage patients sooner by not including their providers in the vaccine rollout. Now we have to reach out, reconnect, and bring them back in.
Turn to Your Data, in Two Ways
This is a moment to be grateful for your electronic health records and the kinds of data and reports the system can supply. It’s easier than ever to identify your most at-risk patients or those patients who are most behind in their preventive care. Practice leaders can pull that data, review it with the team, and then use it to develop a more successful re-engagement strategy. Logan Health (formerly Kalispell) turned to data and dashboards to close care gaps, identify patients in need, and improve continuity of care.
Leaders should also be considering new ways of gathering data on patients who might still feel hesitant. Patients are becoming more accustomed to the convenience of at-home services, like telehealth, and remote monitoring can be an easy and sustainable solution, especially when treating patients with chronic disease. Janis Coffin, chief transformation officer at Augusta University Health System, oversaw the roll out a new remote monitoring program for patients with chronic conditions. Those patients were less likely to be admitted or readmitted to the hospital, were more likely to stay on their medication (because it was obvious when they weren’t, so a team member could call and check-in), and were more satisfied because the care was convenient.
Communicate, Communicate, Communicate
If you’re a practice leader, odds are, your practice operates differently now than it did a year ago. Maybe you offer telehealth, maybe you’ve brought on new or different kinds of providers, maybe you’re supporting patients with new programs. And your safety protocols are almost certainly different.
We’ve all learned a lot and changed a lot over the past year. But have we told patients, especially patients who haven’t engaged in a year or more? Our healthcare system increasingly expects patients to behave like consumers, but they need better information to do so, and that starts at the practice level.
We have to think beyond the way we’ve always communicated though. A recent MGMA Stat poll found that only 3% of practices use email to communicate with patients about appointments, but a study by the Binary Foundation and Healthcare Success found that email communication is a priority for 47% of patients. That’s a substantial gap. Again, if we expect patients to behave like consumers, we have to treat them like consumers and do a better job of meeting their expectations. Amy Lee, chief operating officer of Central Maine Medical Group, has described the return on investment in patient communication they’ve seen at Central Maine Medical Group, in terms of outcomes, access, and opportunity. “Having multiple avenues to access … information, so that the patient can pick up the phone, log onto a computer, or come in when it’s necessary, is very important.”
Tackle the Money Challenge
One factor keeping patients from seeking care could be lost income or lack of insurance. At the same time, a lot of practices are still recovering financially and can’t afford to fall behind on collecting payments. How are leaders supposed to bridge the gap?
One essential plank is tackling claims denials. With all the change in how practices are caring for patients, I suppose we should expect to see some increase in claims denials, but in a recent poll, 69% of practice leaders said their organizations have seen an increase.
With denials, practices take a cash flow hit and patients get bills that may not be accurate and may increase the odds of them not engaging the next time they need care. I still remember going back and forth on a medical bill with a practice three times before realizing it was being denied because my birthdate was wrong in their system.
As practices reengage with patients, they’ll need to take three important steps to avoid denials: make sure patient information is accurate, verify insurance coverage before an appointment, and pay close attention to prior authorization requirements, which are always in flux and are the top reason for claims denials.
The future of medical practices depends on meeting patients where they are—physically, electronically, financially, and psychologically. It’s a tall order, but we’ve been building the resources to make it possible for a decade or more. Reach out, reconnect, reengage, and help patients and your practice achieve better outcomes together.
Medscape. Leslie Kane. Medscape Physician Compensation Report 2021: The Recovery Begins, “Have You Had a Permanent Reduction in Patient Volume?” April 16, 2021.
No Time to Waste: Deferred Care and Pandemic Recovery, A Humana/MGMA Research Report, 2020.
The Commonwealth Fund. Ateev Mehrotra, Michael Chernew, et al. The Impact of COVID-19 on Outpatient Visits in 2020: Visits Remained Stable, Despite a Late Surge in Cases, February 22, 2021.
Health Care Cost Institute. Katie Martin, Daniel Kurowski, et al. The Impact of COVID-19 on the Use of Preventive Health Care, April 16, 2021.
Centers for Disease Control and Prevention. Vital Statistics Rapid Release: Provisional Drug Overdose Death Counts, April 4, 2021.
Binary Foundation and Healthcare Success. Stewart Gandolf and Aaron Clifford. What Healthcare Consumers Want in 2021—Breakdown of Key Survey Results (video), October 16, 2020.