Evolving the patient-experience, one physician at a time

Within value-based care, providers are the strategic signal callers—the quarterbacks of well-being, if you will.

This position charges providers with considerable responsibility for helping patients live their healthiest lives. But to be successful, operating within a complex system with myriad challenges demands collaboration.

That’s why those throughout the industry consider healthcare these days something of a team sport, with integrated care teams largely carrying out a physician’s care plan. And it’s why practices routinely convene PCP-led sessions that bring together experts from areas that influence care delivery– nurses, pharmacists and coders. Some, extending the concept of whole-person health, even expand team membership to include social agency representatives and chaplains.

“After all, a quarterback alone can’t win a football game. And a PCP alone can’t stay on top of all patients’ needs,” says Dr. Gene DiBetta, Chief Medical Officer for Paxton Medical Group in Florida.

“Care teams really work,” he says. “When you have a doctor bogged down seeing 30 or 40 patients a day, there’s no way for them to lead the team and they’re not using their resources to their best potential. I try to drive every care team member to the top of their degree.”

More and more practices are investing in value-based assets, with the bulk of those resources targeting personnel, according to new research by Humana and the Medical Group Management Association. The financial and operational strategies involve bringing on people to be part of the medical practice team, filling new roles and shifting others into positions where they provide greater value to patients and the practice.

Plenary Health Services, based in South Florida, is a managed services organization for 10 practices, facilitating much of the foundational work for its care teams. They coordinate closely with lead physicians and other team members on everything from quality measurement data to understanding procedural guidelines to resolving reporting system issues. The group considers payers like Humana as part of the care team too.

“Everyone is working to achieve a common goal,” Plenary co-owner Tom Bayless says. “There has to be a relationship and a strong base of knowledge about what all is going on (with patients and the practice).”

The care team approach is driving widespread success in Plenary’s network. Based on CMS quality metrics and care gaps tracked by Humana and Plenary, 4 Plenary physicians in 2021 achieved 5-Star ratings and coveted Green Apple Awards. 2 of them were named “Super Stars,” meaning they also earned top marks in member experience categories.

Paxton refers to its care team sessions (often conducted over lunch) as “impact meetings” because the discussions are all about how the individuals and the group collectively impact patients. The teams examine an array of trends and data points to determine those having the greatest negative hit on outcomes and costs and to devise plans to address problems.

“This is a no-brainer,” DiBetta says.