Insight 1: The Role of Non-Physician Practitioners in Value-Based Care Must Grow
Practitioners like physical and occupational therapists and behavioral health providers aren't being leveraged at scale for the value they can create and the outcomes they can improve through their care. Value-Based care programs can't afford to continue missing this opportunity.
Early primary access to these providers expands the reach of physicians. They possess patient care skills and clinical expertise that physician and APPs just don't have.
It's a remnant of an old culture. The education and expertise of these providers is now very high. They have licenses that allow patients to access their care without a physician's referral.
What still stops patients from accessing non-physician practitioners as a "first touch" for care that they are most appropriate for? It's a long list, but at the top of the list we can start with fee-for-service physician incentives, outdated beliefs, and the cultural hierarchy in medicine.
Insight 2: The Importance of Incentivizing All Healthcare Professionals
Healthcare practitioners with the skills, knowledge, and clinical license to reduce total cost of care must be not just point solutions for physicians at risk, but directly accountable for their contributions to improved outcomes, lower total cost of care, and a better, more engaged patient experience.
To start, at-risk providers and payers can contract with them as "Preferred Providers," such as what's available in the ACO REACH program.
Primary care providers should leverage this option and develop a strategic plan to drive more patients there. What would that avoid? Unnecessary imaging, patients living home more safely, better patient engagement, unnecessary surgery, and so much more.
Insight 3: Overcoming Skepticism Towards Value-Based Care
Non-physicians are mostly unengaged in VBC in the present. Except for some nascent episodes of care solutions, the entire focus of VBC has been on physicians and health systems.
We see their presence in MSK point solutions, for example, but this is only a start. It doesn't come close to leveraging the totality of their scope of practice.
Bottom line: We can't access the true potential in value-based care without fully integrating non-physician practitioners, especially physical therapists, occupational therapists, and behavioral health providers. It's not about replacing roles – it's about optimizing our healthcare ecosystem.
The time has come to reimagine healthcare delivery. Physicians and at-risk entities should embrace non-physician practitioners at the top of their scope as partners in value-based care programs and not solely via point solutions. It's not just to fill gaps – it's to build a more efficient, effective, and patient-centered healthcare system.
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