One of our top prerequisites for payment reform legislation (you can see them all here) is that transparent patient activation and patient empowerment measures be baked into the reimbursement system. These include validated measures of patient experience, like the Ideal Medical Practices project’s HowsYourHealth.org survey.
A recent blog post from the project highlights mounting evidence that a positive patient experience leads to better patient outcomes. Some examples, from the post (citations omitted):
- Patients who get care in practices that are less likely to waste their time in the office and are have physicians who are more likely to listen to them are also more likely to have appropriate colorectal cancer screening.
- Patients receiving care in practices less likely to delay care (“sorry, the next available appointment with your doctor is…”) are more likely to show up for care they need.
- Patients who receive care from someone they know (good continuity) have better outcomes.
- Patients who receive good collaborative care (good access, good communication, good continuity, etc) have better rates of appropriate preventive needs met, have better control of their chronic conditions, are less likely to miss time from work/school, and have fewer preventable visits to the emergency room and hospitalizations.
The interesting thing is that there is definitely a link between patient experience of care and important outcomes. As you read these studies it is clear that patients respond positively to clinicians who take time, who treat them with respect (e.g. no intolerable waiting), who listen. We often call this “good bedside manner” though of course it is much more: practices that can do this consistently have good processes in place. It is no fluke that a practice consistently runs on time, gives the provider and patient the time they need, provides high continuity of care.
We can get to this kind of system if we flip the incentives in the fee-for-service system to start rewarding clinical teams for outcomes and quality.
As the debate over ACOs continues to heat up, we urge more attention be paid to the “A” and “C,” as opposed to all the attention lavished on the “O.”