It’s not just patients who get frustrated by the short time they spend with their doctor, primary care physicians (PCPs) are also frustrated by the limited time they have with patients. In fact, the 2016 Physician Compensation Report, based on a survey of more than 19,000 doctors, found the average time spent with each patient is 13 to 16 minutes.
Shorter office visits, a symptom of the current payment system, and increased demands placed on PCPs are contributing to critical shortages across the country, including Western New York. Many PCPs are retiring and fewer medical students are choosing careers in primary care.
When doctors have one eye on the patient and the other on the clock, there is less dialogue, resulting in missed opportunities for getting patients more actively involved in managing their health. Shorter visits also increase the likelihood of the patient leaving with a prescription for medication rather than a prescription for a lifestyle or behavioral change.
PCPs are integral to patient care. That’s why Independent Health is taking steps to address this situation.
First, we partnered with physicians to develop an enhanced annual visit (EAV) with increased reimbursement that enables PCPs to spend more time with our Medicare Advantage members. The EAV has no copayment and incorporates many of the services already provided during preventive and wellness visits, with an expanded focus on the management of chronic disease.
These visits, typically booked by the physician in one-hour increments, are nearly twice the rate of a traditional office visit. This higher payment accounts for the extra time the physician needs to have an in-depth patient discussion, to update medical records, ensure all tests and screenings are current, and to address advance care planning. Through mid-October, more than 46,000 senior members have benefited from an EAV.
Secondly, we continue to expand The Primary Connection (TPC), an innovative physician-led initiative with nearly 190 PCPs from more than 30 practices. These high-performing physicians are reimbursed through an advanced value-based model of care that encourages them to spend the appropriate time with each patient, including more time for those with complex medical needs. The result: greater patient satisfaction and better health outcomes for the approximately 121,000 members treated by these doctors.
Thirdly, we collaborate with the University at Buffalo School of Medicine to encourage medical students to choose primary care as their specialty, and offer opportunities for placement of generalist scholars in a TPC practice, where students experience team-based care in a progressive primary care setting, mentored by a physician leader.
New and enhanced reimbursement models, based on value and quality, will improve access and care for patients, and strengthen the future of primary care.
-Thomas J. Foels, M.D.
Executive Vice President and Chief Medical Officer