This Business Solutions episode of the MGMA Insights podcast features Dr. Alex Ding, associate vice president of physician strategy and medical affairs at Humana. Dr. Ding is a board-certified diagnostic and interventional radiologist and remains a practicing physician.
Dr. Ding shares with us some highlights from Humana’s 2022 value-based care report.
Editor’s note: The following Q&A has been edited for length and clarity.
Q: What are you focused on in your role?
A: A clear passion has emerged to really focus on what our physicians are experiencing, what is happening across the healthcare landscape, and what we can do to help and try and provide some support. So we care about the humanizing aspects of what the day-to-day experience is like for our physicians, for our clinic and hospital administrators. …And so, not surprisingly, as we listen and make improvements, there are themes within what we hear so far from physicians that have really excited us. Growing the number of providers practicing in value-based care arrangements, for example, has seen great progress. Within that we're finding it's so important to be working together, one: to promote preventative care; two: to do all that we can to enable better health outcomes for patients; three: to create a better experience for not only patients but also our providers, and four: to really drive up that value of care for patients and to drive financial stability for our providers.
Q: One of the ways that you’re engaging with the healthcare community is through the annual value-based care report at Humana. Can you tell us about this research and its intent?
A: In short, the intent is to arm today's providers with this information to help them press ahead with intention and wisdom, so that they recognize the benefits of practicing in value-based care, particularly the ones that practices and health systems can see, but also the improvements in experience and outcomes for their patients. And it also happens to be a win for us as a payer because what it really does is fundamentally align incentives, such that we're all focused toward providing the highest quality of care, while at the same time providing flexibility incentives for innovation, all while trying to do it in a cost-efficient manner. And so this year's report has data that we collected back in 2021. And it reflects the outcomes and experiences of over 74,000 primary care physicians who have value-based care relationships with us at Humana. And so those affiliations include more than 1,100 contracts in 45 states and territories.
Q: Patient volume was down during the pandemic, how did value-based care practices work to connect with patient populations?
A: Value-based care practices really overcame the broader healthcare challenges by getting creative in the way they structured their appointments: what was in person, what was virtual, when they were available. And they really were able to stay focused on personalization and proactive care, just as one example. And I think that is because value-based payments really allow for that flexibility in care model innovation and stability in payment to allow for investment in care infrastructure and population health management efforts.
Q: This report says that increased interactions between value-based care providers and their patients reduced avoidable hospitalizations. Can you speak on that?
A: No matter how sick or well you've been as a patient, if your physician in your doctor's office is really making an effort to stay connected with you, to stay in touch with you, to really feel like they know you well enough to follow up with customized reminders about testing or screenings or care that you need, it makes sense that you'd be more responsive as a patient as well. And I think in a fundamental way, value-based care really does do that. (It) incentivizes your doctor to keep you healthy, rather than to only treat you when you become ill. And so when practices have information that value-based care providers have, I think it's easier for them to stay on top of patient communication invitations and follow through. In response, you get patients with better responsiveness. And, yes, we found that these increased interactions between physicians and patients help with important factors like reducing hospitalization. So clearly, a strong doctor-patient relationship has a therapeutic benefit.
Q: What do patient and physician satisfaction scores look like in value-based care practices compared to non-value-based care practices?
A: Our 2021 survey shows that members rated value-based care physicians about 25% higher than non-value-based care physicians in each of the eight categories that we track. I think that patients really appreciate the level of care coordination and the overall care that they receive in these sorts of settings. We generally know that satisfied patients tend to translate into satisfied physicians as well. …
I think the strong patient experience numbers are certainly worth celebrating even though there is this increasing concern of physician burnout, really stemming from fatigue induced by the pandemic - staffing shortages, hectic workloads - that really have practices across the country working to not only improve patient care, but simultaneously physician and clinician wellness as well. And in fact, I know this is something you're familiar with, according to an October 2021 MGMA Stat poll, a third of medical practices had physicians either retire early or leave due to burnout. In addition, we did a joint study at Humana and MGMA, in 2022, that showed that almost two thirds of physicians report currently experiencing burnout. … And I do often hear about how strong care teams allow everyone to work on the tasks that their training demands, which should improve professional satisfaction, and it is something that value-based care enables. But we do believe that the more these changes drive up patient satisfaction and allow physicians time to do what they trained so diligently to do, physician satisfaction would follow that upswing.
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The MGMA Insights podcasts are produced by Daniel Williams, Camille Burch, Rob Ketcham and Decklan McGee.
MGMA Events: This episode is brought to you by the Medical Practice Excellence: Financial and Operations Conference 2023, which will be held in Orlando, FL, March 19-21. During our premiere spring event, attendees will gain key insights from both disciplines and learn about topics that shape the future success of medical practice organizations. Go to mgma.com/mpe23 to learn more and to register today.
Humana: The latest Value-Based Care Report from Humana outlines many interesting findings and highlights how some physician practices found creative paths to success. Check it out now at Humana.com/VBC. Humana is working closely with physician practices on their value-based journeys.
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