What Makes Better Care? The Series. Part 7: Patient Choice and Accessibility

Principle 7: Patient Choice
As the House and Senate get close to releasing their versions of comprehensive payment and delivery reform legislation, the Campaign For Better Care, with the help of students from the Harvard School of Public Health, will be doing a series of blog posts this week highlighting our 10 Principles for Better Care.

7. Patient Choice and Accessibility: The payment system should preserve patients’ provider choice. Patients must have access to caregivers with linguistic and cultural capacity to provide effective care within geographic area. Payment systems should promote patients’ continuity of care with their providers. Patients should have access to clinical trials and medically necessary out-or network care, including out-of-state providers.

Key policies:

  • Patients must have the ability to get care from any provider covered under their insurer’s plan. The Massachusetts market already has limited and tiered insurance plans, where insurers limit choices of providers. Moving to ACOs should not bring yet another layer of restrictions on patients. A good ACO should demonstrate the value to patients of staying in the family, though the benefits of care coordination, shared communications and practice styles. As the saying goes, the best fence is a good pasture. No patient should be limited in their choice of providers by their providers.
  • Patients must be allowed to seek specialized care services that may not exist within an ACO. Specialty care in particular must not be limited by ACOs and global payments. Highly specialized services might be available from only one provider, and patients who need those services must not be shut out of those providers.
  • Patients should actively be able to choose to participate in an ACO and be given full information about their care plan, and how their care is being paid for. Despite the proliferation of global payment systems in Massachusetts, many patients are not informed about how their care is paid for. Providers and insurers must provide full transparency to patients on all the details of the reimbursement system that affects their care. Patients should ultimately be the decision-makers about the care model they want to participate in.

Transparency and choice are the linchpins of patient-centered care. Our health care system must be structured to put us in the driver’s seat.

Better care means the promotion of patient choice and accessibility.
-Martyna Skowron

About HCFA

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