Primary Care Providers Can Lower the Cost of Healthcare

Posted by Continuum on Apr 18, 2017 11:02:00 AM

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.

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Topics: cost of care, lower cost of care, independent physician, hospital employment, Primary Care Providers

Managing Patients' Cost of Care Essential Under New Reimbursement Models

Posted by Continuum on Apr 18, 2016 11:00:00 AM

Quality. Cost. Patient Satisfaction.

There are the three main areas in which physicians will be measured, as our healthcare system shifts from volume to value. The Centers for Medicare and Medicaid Services (CMS) has already begun tying reimbursement to these measures, and commercial payers are creating similar, value-based models.

In a previous post, we discussed how doctors can succeed under the new quality metrics. Here, we’ll explain how physicians can meet cost benchmarks.

Defining “cost”

The cost that’s relevant to payers is the annual amount spent by patients and their insurance providers for the patients’ care. It is not the provider’s cost of doing business, such as overhead costs. Moreover, “cost” is the total amount received by all of a patient’s providers.

To illustrate: Dr. Smith is a primary care physician with 100 attributed patients. He received $10,000 for their care. Dr. Smith’s patients also spent $90,000 with other providers. Therefore, Dr. Smith’s cost of care is $100,000.

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Topics: value-based reimbursement, medicare, CMS, lower cost of care

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