Lehigh County Health & Medicine Fall/Winter 2020 - 11

L C M E D S O C .O R G

of health care is in the process of switching As the PCP pursues quality in practice the safety of patients and staff, and pivot to
to a value based model of reimbursement, (completing annual wellness visits, closing telemedicine to ensure patients have access
which is expected to be significant in the care gaps, monitoring episode costs, and to uninterrupted care.
future. Since value based care transfers coding accurately), economies can result
the emphasis from diagnosing sickness to that ripple across the population.
Keeping flexibility, innovation, and
keeping people well, primary care takes a
readiness as staples, primary care practices
frontline role. The primary care office serves
For example, if during a wellness visit, a that continue to grow will become better
as ground zero, where the physicians and patient mentions bowel changes, the PCP equipped to manage change. According
staff can get an early jump on a problem can prescribe a colonoscopy. If during the to one source, " To successfully practice in
that could become a serious health threat screening, early colon cancer is diagnosed, the future, physicians will need a mix of
if left unattended.
then cured, it may contribute to overall relationship-oriented skills to connect with
cost savings. Contrast that to a patient patients and colleagues, quantitative skills to
An excellent tool for early interception is who did not visit a PCP and their cancer interpret complex data, a strong foundation
the annual physical, or for those age 65 and advanced undetected. This would take more in prevention to deliver wellness-oriented
older, the Medicare Annual Wellness Visit. resources and potentially cost more to treat care, and a robust understanding of busiWhen physicians see patients once a year and manage.
ness and economics of medicine to drive
even when they are well, they are able to
population health. " ***
view the big picture. Besides any particular
Another example is when a patient visits
illness, physicians can evaluate factors such the primary care office rather than going
This vision of the future is in the works
as how patients are getting along at home, to the Emergency Department (ED) in now. Hospitals, physician hospital orgaand whether their life needs are being met. the hospital. Many health problems can nizations, and providers themselves are
It's a good check-in for screenings relevant be initially addressed by a PCP, and PCP prioritizing quality primary care and are
to the patient's age and a review of family visits are less expensive than ED visits for passionate about strengthening access as a
health history. This is also an opportunity patients and insurers.
core component to better care and value.
for PCPs to address mental health. Part of
According to Primary Care Progress, " Access
the annual wellness visit is a depression
The impact of the pandemic in terms of to primary care helps keep people out of
screening; however, the visit can be the compelling the utilization of virtual visits emergency rooms, where care costs at least
opportunity for the physician to take note of has been significant and opens up another four times as much as other outpatient
any perceived problems with drugs, alcohol, option for patients. They like video visits care. A study in one ER found that nearly
falls or risky behavior, and discuss those because they are more convenient and, 60% of the patients' problems could have
issues with the patient.
during the pandemic, perceived as safer than been addressed in a primary care clinic for
going into the doctor's office. For physicians, a savings of a whopping 320-720% - that's
These days, especially as we feel more vul- it's an excellent way to gain insight into a a value of three to seven times less. " ****
nerable, there's an increasing understanding patient's condition, state of mind, and even
and acceptance of seeing the doctor when their home environment. The overwhelming SOURCES:
you're well. Employers are getting onboard positive reaction to this avenue of care *B. Starfield, L. Shi, and J. Macinko, " Contribution
Primary Care to Health Systems and Health, "
by offering discounts to employees on their has insurers evaluating the possibility of of
Milbank Quarterly, Sept. 2005 83(3):457-502; and
health insurance if they complete an annual continuing reimbursement for video and S. J. Spann, " Report on Financing the New Model of
Family Medicine, " Annals of Family Medicine, Dec.
wellness visit. Payers are seeing results in phone visits beyond the end of 2020.
2004 2(2 Suppl. 3):S1-S21; https://www.primarycareterms of lowering the cost of payouts, so
they are joining employers as advocates of PRIMARY CARE IN TRANSFORMATION
** https://www.aamc.org/news-insights/press-releases/
this form of preventive medicine.
Even before the pandemic, primary care new-aamc-report-confirms-growing-physician-shortage
was challenged. Fewer medical students were *** https://www2.deloitte.com/us/en/insights/industry/
taking this route, contributing to what has health-care/future-of-primary-care.html
In order to bring more value for patients been estimated as a shortage of 21,000 to ****https://www.primarycareprogress.org/
into the health care equation, it's imperative 55,000 physicians by 2033**. When the primary-care-case/
that physicians work together. From the pandemic hit, primary care visits declined
insurer's point of view, physicians and by 20 percent, and many primary care
their staffs are part of a team of hundreds practices folded. We have been fortunate in
of physicians managing a population of the Lehigh Valley to have retained most of
patients. Since patients are attributed to our primary care practices, even though they
their PCP, what happens in the family were stretched, had to innovate, make rapid
medicine office is of utmost importance. changes to their practice environment for
FALL / WINTER 2020 | Lehigh County Health & Medicine 11

http://www.LCMEDSOC.ORG https://www.primarycareprogress.org/primary-care-case/ https://www.primarycareprogress.org/primary-care-case/ https://www.aamc.org/news-insights/press-releases/new-aamc-report-confirms-growing-physician-shortage https://www.aamc.org/news-insights/press-releases/new-aamc-report-confirms-growing-physician-shortage https://www2.deloitte.com/us/en/insights/industry/health-care/future-of-primary-care.html https://www2.deloitte.com/us/en/insights/industry/health-care/future-of-primary-care.html https://www.primarycareprogress.org/primary-care-case/ https://www.primarycareprogress.org/ https://www.primarycareprogress.org/primary-care-case/

Lehigh County Health & Medicine Fall/Winter 2020

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