Today’s patients have numerous choices of hospitals, urgent care, and other ambulatory care centers when they seek treatment. While primary care providers (PCPs) can typically help patients with these decisions, patients sometimes visit these facilities before consulting their PCPs for treatment or preventative care. Expensive hospital visits can drive up healthcare costs and have a negative impact on quality overall—but fortunately, PCPs have some options to help keep costs down.
PCPs lower healthcare utilization
Independent PCPs emphasize quality of care through their personalized interactions and relationships with their patients. When PCPs are readily available in a community, patients are less likely to seek treatment at a specialized facility, hospital, or urgent care center.1 Unnecessary emergency room visits are a drain on the nation’s healthcare system when the source of the visit could have been treated or prevented by a primary care provider.
PCPs focus on establishing a rapport with their entire patient population. These relationships allow doctors to draw conclusions about a patient’s overall health or potential illnesses on an ongoing basis. Consistent, meaningful visits build a bond between patient and provider, which encourages the patient to seek treatment from his or her PCP over a hospital physician.
Hospital-owned physicians stick to their network
Many patients who visit hospital employed physicians are likely to pay more for lower quality care, due to the nature of the hospital structure. Employed physicians frequently refer patients to their parent hospital, even if the patient could receive better care at a different facility. A study conducted by Stanford researchers Laurence Baker, Kate Bundorf, and Daniel Kessler noted that employed physicians sent nearly eight out of ten patients to their higher-cost parent hospitals, and those hospitals have a 1.8 percent higher chance of being lower-quality facilities.2
Independent physicians are not obligated to refer patients to specific specialists. An independent PCP can refer his or her patient to the facility that will best treat the patient’s illness, disease, or injury—regardless of affiliation. Independent physicians capitalize on their status and ensure that their patients receive the best possible care from the highest quality facilities.
PCPs can focus on transitional care for patients
To guarantee quality transitional care after a patient has been hospitalized, PCPs must forge connections with hospitals to share and transfer digital patient records. The transfer of accurate patient information from hospitals to independent practices is imperative to ensure that all patients receive strong continuity of care, following hospital discharges. Since lower-quality hospitals often lack proper transitional care, many patients are subsequently readmitted, leading to higher costs for patients and payers.3 PCPs focus on reconciling patient discharge information and medications so that their patients can remain healthy after their hospital visits.
Visits to independent PCPs lower the cost of healthcare for patients and payers. The healthcare industry must continually support independent physicians to mediate the rising costs in today’s healthcare environment. A growing number of physicians have turned to Clinically Integrated Networks (CINs) and outside practice partners for clinical and administrative support.
CINs can negotiate more aggressive contracts with payers, and independent practices can gain the benefits of increased network capabilities through the association. Outside practice partners work with private practices to alleviate the stress of administrative and financial burdens. These support options allow physicians to focus on patient health and drive down the cost of healthcare, while still working to meet the quality benchmarks necessary to succeed in our value-based care environment.