Physicians focus on an over-all approach to help patients navigate through their patient journey

The ultimate goal of physicians is to keep their patients healthy. But the journey from illness to wellness for a patient often isn’t a smooth one.

America’s complex, fragmented care delivery system presents myriad twists and turns, challenges and hurdles, and inconveniences that mar the patient experience and, all too frequently, the experience of the physician working to help patients navigate their journey.

Practices in value-based arrangements focus much of their efforts not just on how their patients feel physically, but also on how they feel about all that encompasses a visit to their primary care physician, and it shows.

A 2021 internal Humana survey similar to the Consumer Assessment of Healthcare Providers and Systems (CAHPS), a key Stars patient experience metric, showed members rated value-based physicians roughly 25% higher than non-value-based physicians (3.9 Stars vs. 3.1 Stars) in each of 8 categories. They applauded the level of care coordination and overall care provided.

The largest differences between the provider groups were in the overall rating of the health plan and the overall rating of drug coverage, with value-based physicians scoring 1.2% and 1% higher, respectively.1 That’s significant because 1 point can represent as much as a 1-Star difference in performance on CAHPS measures.

Additionally, Humana’s Net Promotor Score (NPSr®) illustrates the tighter patient-provider-payer connection and relationship when health plan members are tied to value-based PCPs. Those members rated Humana nearly 16% higher than members treated by non-value-based physicians. The score of 57 for value-based vs. 49 for non-value is considered statistically significant.

The score is a relationship-level indicator of customers’ loyalty to a given company. It is derived by asking “how likely are you to recommend Humana to a friend or family member” on a relationship survey with an 11-point scale, and then calculating a score by subtracting the percent of respondents giving the lowest scores (0–6) from the percent of those giving the highest score (9 and 10).

Why it matters

The patient and physician experience are intertwined. Satisfied patients tend to lead to satisfied physicians.

The strong patient experience numbers, though, come amid admissions and increasing concerns of physician burnout stemming from fatigue induced by the pandemic, staffing shortages and hectic workloads that have practices nationwide devising strategy on how to bolster the experience for those receiving and delivering care.

In fact, one-third of medical practices had physicians retire early or leave due to burnout in 2021, according to an Oct. 26, 2021, MGMA Stat poll. The 2022 Humana-Medical Group Management Association (MGMA) research finds almost two-thirds (64%) of respondents report currently experiencing burnout— feeling overwhelmed and/or emotionally drained.

There were some bright spots in the statistic:

  • 70% of practice leaders surveyed said they are strongly engaged in their work, while 30% reported only “a little engaged” or “somewhat engaged.”
  • Almost 3/4 practice leaders in organizations participating in value-based plans said they were somewhat or very satisfied with their current employer.

The way forward

Recognizing the negative stigma in the minds of many patients when going to the doctor’s office, many value-based practices have transformed their approaches to make clinics inviting destinations for seniors.

Some like Florida-based CareMax opened an activities room that serves as a festive hub where a DJ is brought in a couple of times a month to play music, fostering high-spirited interactive dancing and promoting fellowship for the few dozen seniors who regularly participate. Patients often arrive before their appointments and stay well after for friendships.

“All the activities give them a time of distraction from just being at home without having someone to talk to, and here they make friends,” says Iraida Goenaga, Center Administrator for CareMax Medical Center of Westchester in Miami. “I enjoy the events because it puts smiles on their faces.”

The pandemic spurred higher workforce turnover, and clinics continue to struggle to bring on new physicians and staff. “With less access, there is less ability to interact with patients,” says Dr. Amy Scanlan, Medical Director for UCHealth Coordinated Care Colorado.

In a traditional non-value-based model, that means patients may become lost because they are not seeing their physician. Then, when they return to the office, they are often sicker and require more care.

In a value-based care model, practices can rely on their teams to conduct outreach when patients are unable to see the primary care provider.

Improvements in technology also allow for more data available to those teams, ultimately helping ease the burden on the primary care physician. Relying on registries to target the highest-need, most-complex patients, integrating claims data into the electronic health record and incorporating health plan data such as Humana’s Member Summary positions a practice to ensure its highest-risk patients are still taken care of. This helps to streamline patient care and to mitigate burnout for frontline physicians.

“These tools are helping frontline providers with a culture shift,” she says, noting that physicians’ work goes well beyond treating those directly in front of them. “How do I access the people that are not in front of me? How do I make sure they’re getting the kind of care they deserve and need? How do I know they are not in and out of the ED because they are not able to see me?”


  1. Humana internal data.

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