Read this if you are a primary care provider, leader, or administrator in a primary care practice or hospital ownership setting.
Valuing primary care providers
One doesn’t have to venture far into healthcare headlines over the past two decades to find robust discussions about healthcare worker shortages, and more recently, provider well-being. In this sad new world of low satisfaction and increasing burnout, leaders and administrators across the healthcare delivery spectrum are struggling to find ways to make provider happiness a priority. Nowhere is this felt more acutely than in primary care. So, it begs the question, how are we—as healthcare administrators and strategic leaders—valuing our primary care providers?
The idea that volume or incentive-based compensation models will solve all motivation and productivity concerns is neither realistic nor sustainable. Typical models champion wRVUs and maybe some patient/procedure per hour/day metrics, but are these compelling for primary care providers? We need to remember that many of these practitioners made the conscious decision to practice in primary care, which was not likely driven by a desire for high income. In fact, making the motivation all about financial incentives can often backfire. While it may potentially or temporarily increase or “improve” results, it is often at the cost of patient care and can ignite further burnout.
Conversations with primary care providers
Actively listen to the physicians and associate providers in your organization and you will quickly hear how important it is to recognize the complexity of their patient population. But being heard is just the starting point. Conversations with providers need to lead to an organizational investment in metrics that show that you value and care about what your primary care providers value and care about. This cannot be overstated or underestimated.
Empanelment (or “panelization”) is a fundamental metric for any organization with a primary care presence of any significance, and this metric should be shared with those primary care providers. Transparent reporting in this metric alone would be a sea change for many in our current environment.
Measurement for measurement's sake is not enough
But measurement for measurement’s sake is not enough, because if we are measuring something, we need a goal we are seeking to achieve. Knowing (or thinking we know) the right size panel for our providers is not a simple answer. Every community is different, and as any provider will tell you, they each have different mixes of complexity. They may see a drastically different patient population than even the provider with whom they share an office, so measuring all patients equally is not a valid approach.
Empanelment is as complex as each patient when we consider socio-economic factors, chronic conditions, and other determinants of health. Each patient is unique and has a unique level of complexity related to their care, so treating each patient like a ‘1’ simply doesn’t work. Complexity demands differentiation of some sort to better communicate and manage the workload involved. This is why weighted empanelment—assigning a comparative value per patient in order to reflect appropriate complexity—is so helpful. Many organizations have developed their own weighted models for years, often with mixed results. Because as soon as we believe we have solved a problem, a new one is created. Now we have to decide what criteria determines complexity, and how that will actually be calculated. Once that is done, we realize that the output has to be validated, repeatable, and most importantly, it needs to be comparable.
Historically, most chosen criteria are either incredibly hard to track, impossible to validate, or a painful mixture of both! Over the last twenty years or so, weighted empanelment models and methods have been built, scrapped, used on a limited basis or for limited purpose, and are often very burdensome to manage or duplicate.
Research-verified weighted panel calculations
BerryDunn has helped healthcare delivery organizations operationalize research-verified weighted panel calculations: one building block toward a better model that fits the value-based future, brings insight to both providers and administrators, and creates value in the communities they serve.
Our model is easy to implement and understand, providing organizations with an important tool and metric that can be used to effect needed change to drive and enable an improved administration-provider relationship.
If you have any questions regarding the information in this article or would like to have a conversation about primary care provider empanelment or provider compensation and productivity, please contact Markes Wilson.