Exploring chronic care management adoption for primary care physicians August 8, 2018
As the population in the US ages, more patients will need care for chronic conditions. Those over the age of 65, a group that is increasing in numbers as Baby Boomers enter the age of retirement and Medicare eligibility, are more prone to conditions such as arthritis, hypertension, diabetes, and other chronic conditions that will require management by primary care physicians.
A recent survey conducted by Quest Diagnostics explored the adoption of chronic care management. The survey, involving 801 primary care physicians and patients over 65 with multiple chronic conditions, found that primary care physicians feel “overwhelmed and overworked.” These physicians want to spend more time with the patients who need them most but feel their lack of time impedes the quality of that care.
Specifically, the survey found that “almost nine in ten PCPs (86%) say they have felt unable to address the needs of their chronic care patients adequately, with almost three in ten (28%) saying this happens a lot. For most physicians—85 percent—lack of time is the key culprit.”
Although most (95%) of the physicians participating in the survey said they are in primary care because of a desire to care for the “whole patient,” two-thirds (66%) of them say they “don’t have time to address social and behavioral issues, such as loneliness or financial concerns, that could affect the health of their patients,” possibly contributing to or exacerbating chronic conditions among those patients. Only 9% of the physicians participating in the survey are “very satisfied that their patients are getting all the attention they need to care for all medical issues.
Patients with chronic conditions also typically require continued medication and, in fact, account for 83.1 percent of all prescriptions in the United States. The surveyed physicians indicated they felt the need to follow up with these patients to ensure they understand their instructions fully, with 88% saying they are “concerned their Medicare patients with multiple chronic conditions are not taking their medications as prescribed.”
An additional challenge for primary care physicians treating patients with chronic health conditions is the Medicare reimbursement schedule. Most of the physicians surveyed stated they need to see these patients multiple times throughout the year, to properly manage their conditions; however, under Medicare, patients are eligible for an introductory preventive visit within 12 months of qualifying for Medicare and an Annual Wellness Exam every year thereafter.