High-Touch Practice Models—Concierge and Direct Primary Care
Though they come at prices most people can’t afford, concierge and DPC practices give patients ongoing direct access to their primary-care physicians. Annual concierge fees of $1,500 to $2,500 are in addition to regular health-insurance premiums. DPC practices do not accept any kind of insurance, but can therefore boast greater pricing transparency—a plus. Monthly patient membership fees cover unlimited doctor visits.
Only about 12,000 of the country’s one million licensed healthcare professionals have adopted either model, but the number is increasing. Physicians, too, like high-touch practices, because they’re generally smaller and easier to administrate, and they provide guaranteed revenue. And they like them for the same reason their patients do: they believe that better doctor-patient relationships are healthier—literally.
High-Touch Services—Health Advocates and Coaches
Healthy patients who set wellness goals generally embrace digital ecosystems. Medicare and Medicaid patients addressing chronic conditions won’t or can’t, on their own. Still, an active 30-year-old might hire a health coach to motivate them, and a diabetic 75-year-old might turn to an advocate to navigate online health applications and patient portals. They might need an advocate to interpret test results, or even to challenge a doctor’s recommendations. Innovative companies that understand the role human touch plays in healthcare are responding to these differing needs.
Personal Patient Outreach
According to CMS, in 2020 over 24 million people were enrolled in Medicare Advantage Plans in the U.S.6 We know that closing care gaps is the key to better outcomes for senior patients, and that closing those gaps begins with connecting with patients about their healthcare. Engaging with patients is always important, and with older populations, it’s essential to do so in a caring and personal way. One example of an organization that offers better healthcare for older patients is WellBe Senior Medical. This Leverage Health portfolio company works with Medicare Advantage plans to take full risk and then care for patients in the home or wherever the patient needs to go for care.
The world was far less populated and less complicated in the decades when seniors started their families and careers. Some doctors still made house calls, and personal reminders from receptionists about checkups or vaccines were not unusual. That’s why a service that reaches out to older patients with personal phone calls has a place in today’s world.
High-Touch Outreach in the Digital Age
Such an outreach service helps older at-risk patients schedule appointments with the right providers at the right time, and helps them follow providers’ recommendations—e.g., taking their medications as prescribed. Personal and proactive outreach agents schedule care before a condition has progressed or resulted in a health crisis. Patient outreach also can ensure that seniors experience better relationships with their physicians; this, too, leads to measurably better outcomes.
Payers and Member Outreach
It’s a partnership. Payers provide the data, and the outreach company simplifies the healthcare process and improves provider access for members uncomfortable with digital technology. Working with outreach programs lets payers close Healthcare Effectiveness Data & Information Set (HEDIS) gaps, improves CMS Star Ratings, and increases ROIs. As members can take better advantage of their benefits, these health plans ultimately gain prestige.
For most payers, relying on an in-house department to reach out to older and/or at-risk members proves challenging and ineffective. Payers see much better results when they employ an outreach company with proprietary technology tailored to their needs and agents who skillfully connect with plan members using tried-and-true scripts. The best outreach programs will also gather overlooked or previously unknown data and share them with health plans and network providers, creating a valuable feedback loop.
Staying on top of their healthcare can be confounding for older Americans. At worst, their health suffers; at best, the many extras that health plans offer—so that members can advocate for themselves—miss the mark. Plans and providers know they need to look forward, and online practices, telemedicine, and digital quality measurement are the ways of the future.