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Growing and sustaining high-performing primary care practices

Insight Article - September 22, 2021

Marketing/Social Media

Patient Access

Practice Efficiency

Donald J. Callahan MBA, FACMPE
Safe, comprehensive and coordinated care for our patients should always be top priority. Primary care physicians (PCPs) are at the center of this care and are instrumental in navigating patients through the healthcare continuum. But patient trust and a viable primary care practice aren’t built overnight.

To expedite and sustain growth of primary care practices, healthcare leaders should consider the following guidance in the areas of promoting access, practice development and marketing, and delivering high performance. 

1. Promoting access

The following access criteria should be in place as a baseline when establishing a practice and/or evaluating growth potential. Without these access tools in place, growth opportunity will be limited.

Patient-centered hours

Mornings, evenings and weekends to accommodate patient schedules. Today’s environment is one of instant gratification. Patients tend to take the path of least resistance in seeking healthcare where and when it is convenient to them. As a result, growing numbers of urgent care centers and retailers (e.g., CVS and Walgreens) have started staffing providers on site to tap into this opportunity. The best interest of the patient calls for continuity of care, which improves patient satisfaction while lowering the likelihood of ED and hospitalization rates. Offering convenient hours for patients who work during the day is one solution — a minimum of two evenings per week and one Saturday per month to start. Early hours are another option to enhance access in improving overall convenience to patients. When evaluating your schedule, focus on the number of sessions (four-hour blocks of time), which include patient-centered hours; 20% to 30% of your sessions at a minimum should offer patient-centered hours.

Telemedicine

Embrace technology and encourage the use of telemedicine as a way for patients to receive initial or follow-up care with added convenience to in-person options. The COVID-19 pandemic catapulted us forward in the acceptance of virtual care delivery via telehealth. Patients have been quick to adopt this new technology. We have learned that telehealth is a practical way to screen patients for symptoms or monitor those who are infected, and it is also a convenient way to protect those who may be most vulnerable to the disease’s sometimes fatal effects. There are multiple use cases for telehealth that can help improve access and convenience:
  • Urgent care services/extended access
  • Chronic care management (CCM)
  • Post-hospitalization visits
  • Advance care planning
  • Wellness visits and preventative care.
Telemedicine can be offered to supplement extended hours. By being available to your patients, you are enhancing their experience and improving their care. Again, convenience is king, and your patients will appreciate it.

Online scheduling

Maintain an open schedule with very few restrictions to allow patients flexibility and convenience. Scheduling platforms allow patients to book appointments online, linking directly to each provider’s schedule. If you restrict your scheduling template to only allow patients to see available physicians, same-day appointments, or new patient appointments during certain blocks of time, it will reduce visibility into all available appointments. Open access is incredibly important when growing a practice, which is why we recommend an open scheduling template. This online tool is another great way for patients to access your schedule.

2. Practice development and marketing

Once the above access tools are in place, consider the timing of marketing and business development initiatives. A marketing team can work closely with you to ensure you are optimizing your online and community presence. They will also work with local distribution channels to ensure your message reaches the appropriate audience.

Web presence

Ensure information is correct on the practice website. The practice website is a great place to market yourself for free. There are several simple rules that will improve your web presence. Be sure that your provider page has recent headshots. Also, be sure to include provider bios and education/training experience so that patients can learn more about your providers. Consider adding videos to profiles as well, allowing providers to introduce themselves and detail particular areas of interest. You could also create a health talk video series, which can be aired on your practice’s website, as well as local community television. This offers the opportunity for providers to speak about a particular area of interest to a broader audience.

Social media

Encourage patients to leave reviews and monitor websites such as Google, WebMD, Vitals and HealthGrades to ensure accurate information. Patients will receive satisfaction surveys after their visit, which will provide valuable feedback regarding their experience. They will help to identify areas of strength and opportunities for improvement. It is also important, however, to monitor your practice’s online presence. There are several external websites where patients can rate providers and comment about their experiences. Encourage patients to leave positive reviews, but also periodically check that the practice’s information is accurate. Some sites may carry forward inaccurate information, such as practice address, if the practice was at another location previously. Updating this information will point patients in the right direction, not only helping them locate your practice but also understanding more about your practice and the services it provides.

Open house

Have an open house for new patients to meet your providers and staff. An open house offers an opportunity for patients to meet your providers and staff. Offer services such as free blood pressure screenings and educational material. Provide business cards and marketing collateral, as well as light and healthy snacks/refreshments. Open houses can evolve into regular community education sessions on topics such as diabetes, flu, nutrition, wellness, etc.

Community outreach

Engage with marketing and business development to take advantage of community speaking engagements. It is critical to be involved in the community. In most cases, patients seek primary care services within a 10- to 15-minute drive of their homes. By being involved in the community near your practice, you increase your chances of meeting potential patients. Introduce yourself at local nursing homes, assisted living communities, pharmacies and to specialists. Consider joining local groups such as the Lions Club, Kiwanis International, and/or Rotary International, and offer to provide education sessions on a particular health topic. This will show potential patients your involvement in the community where you practice.

Unassigned patients

A recent study published in JAMA Internal Medicine reported a decline in the number of Americans who have a primary care provider.1 An estimated 25% of Americans do not receive primary care services, which means that you can work closely with an affiliated hospital’s emergency department (ED) and discharge teams to have them refer patients who don’t have a PCP to you. Ensure that your operations team lists your practice as accepting new and unassigned patients on your practice website, on payer websites, with local emergency departments, etc.

Similarly, insurance companies often assign patients to providers based on geography, and in many cases patients simply select a provider when enrolling in a new insurance plan. Review your practice’s attribution list regularly. There is always opportunity for staff to reach out to patients who have never been to your office but are otherwise assigned to you. This is a great opportunity to make a first impression and ensure these patients are receiving proper care.

Flu clinics

Seasonal flu clinics are a great way to avail yourself to patients. Your practice can partner with local businesses to provide flu clinics and other remote testing. Volunteer to work flu and other clinics in the community to get in front of potential patients and direct those who don’t have PCPs to your practice for more routine care.

3. Delivering high performance

Once operational efficiencies are in place and marketing is being properly utilized, use these tools to maintain performance levels.

Preventative visits

Annual preventative care visits are a great way to bring patients back to the office, while also serving as a way for patients to be attributed to your practice. Other benefits include closing gaps in care, updating patient charts, medication reconciliation, identifying high-risk patients, improving risk scores and risk stratification. Closely monitor your patient panel to ensure annual preventative visits and Medicare Annual Wellness Visits are scheduled. Have staff reach out to patients who have not received preventative care within the past 12 months and educate them on the importance of preventative care. Schedule patients for preventative visits and maintain a recall list of those who opt to not schedule upon checkout.

CCM

According to the Centers for Disease Control and Prevention (CDC), nearly 60% of adults in the United States have a chronic disease, while 40% have two or more chronic conditions.2 It is important to closely monitor this population’s conditions, medications and lifestyle. Depending on the severity of their condition and how well it’s managed, patients with chronic disease should generally be seen every three to six months. Reach out to patients who have not been to the office and educate them on the importance of chronic care management. Schedule patients for chronic care follow up and maintain a recall list of those who opt not to schedule an appointment at checkout.

Patient communication

Personally call patients back with test/lab results. While caring for patients, it is difficult to view healthcare as part of the service industry. By doing so, however, you can differentiate yourself from other providers. Calling patients back after their visit to check on their illness, injury or new medication is a relatively easy way to show that you care about them. This direct communication with patients provides a competitive advantage and will help set your practice apart from others while helping your providers to get to know your patients better. Word of mouth is an incredibly powerful tool in healthcare. By following up with your patients, you increase the likelihood of them recommending you to their friends and family.
Take time to answer questions patients may have. Never underestimate the importance of creating a strong relationship with your patients. After all, they are entrusting you with their health, so the bond you create with them is critical. You should always prioritize this relationship. Patients should feel as though they are being heard and not rushed through their appointment (even if you are running behind schedule). Again, this experience is likely to be shared with family and friends.
Assist patients with scheduling referral appointments to specialists. Navigating the healthcare landscape is incredibly difficult for patients. Providers should utilize the tools they have to help ease this process for patients. When referring to specialists within the medical group, have your staff schedule appointments prior to checkout. This will save patients time and will increase the likelihood of them seeing that specialist. If referring to a specialist outside the medical group, have your staff provide the patient with literature and contact information for the specialist’s office. If time allows, staff can call the specialist’s office on the patient’s behalf to assist with scheduling. This will also improve your relationship with the specialist’s practice.

Coordinated care

Perform care team huddles daily to review the schedule and develop a plan. In line with strong communication, daily care huddles are a great way to ensure your team is on the same page. Even better, you could conduct huddles prior to or after each session to review follow-up tasks (see Table 1).


 

Notes:

  1. Levine DM, Linder JA, Landon BE. “Characteristics of Americans With Primary Care and Changes Over Time, 2002-2015.” JAMA Internal Medicine. 2020;180(3):463–466. doi:10.1001/jamainternmed.2019.6282.
  2. National Center for Chronic Disease Prevention and Health Promotion. “Chronic Diseases in America.” CDC. Available from: bit.ly/3x0toK3.
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About the Author

Donald J. Callahan
Donald J. Callahan MBA, FACMPE
Vice President, Business Development RWJBarnabas Health West Orange, N.J.

Donald.Callahan@RWJBH.org

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