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The Primary Care Quarterback: How great primary care means better care management

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In the game of football, the quarterback’s role is to coordinate and act as the leader of the offense. The quarterback works with other team members and coaches to produce the best possible play each time, so that the team can reach the goal at the end of the field. In healthcare, the primary care physician plays the role of quarterback. Your goal is a positive outcome for your patients, through better primary care and better care management.

It all starts with great primary care. Research has shown that the quality of healthcare, including the costs incurred, is strongly linked to the availability of a primary care physician for the patient. In fact, it has been found that patients with “access to a regular primary care physician have lower overall health care costs than those without one, and health outcomes improve.” Further, in “areas of the country where there are more primary care providers per person, death rates for cancer, heart disease, and stroke are lower and people are less likely to require hospitalization.”

The goals of care management include reducing those hospitalizations and reducing the costs of healthcare overall. Primary care can achieve these goals, as well as provide higher quality care to patients, by coordinating their care appropriately.

A study published in the Annals of Family Medicine found a number of attributes of high-value primary care practices that cohered into three themes:

  • Risk-stratified care management
  • Care selection of specialists
  • Coordination of care

These three areas “reflect physician recognition of the need for ‘care traffic control’ to help patients with complex conditions or treatment plans” navigate the healthcare system for better outcomes.

The study found that high-value primary care resulted in:

  • Decision support for evidence-based medicine. Primary care teams ensure that patients receive evidence-based care and treatment, noting guideline reminders in the patient’s electronic health records (EHRs) for other physicians.
  • Careful selection of specialists. Developing relationships with specialty providers whom the primary care physician trusts and continuing to communicate with those providers are critical to quality outcomes for the patient.
  • Standing orders and protocols. With protocols for uncomplicated illnesses and disease management, the primary care team can use standardized workflows for patient care.
  • Balanced compensation. Value-based care accounts for “care quality, patient experience, resource use,” and primary care practice improvement activities.
  • Care coordination. The primary care team monitors patients, including visits to specialty providers, labs, and diagnostic tests, to ensure patients complete their referrals, schedule follow-up appointments, and adhere to treatment and medication instructions.
  • Risk-stratified care management. Through the delivery of quality primary care, each patient receives care based on his or her unique needs, whether that involves office visits, monitoring and guidance provided by a care manager, or communication after the visit to clarify diagnoses and care instructions.