Strong patient relationships are important for better health and quality of care. Quality-based compensation has continued to evolve with quality-based care and performance metrics. Practices and health systems have aimed to find the balance between clinicians seeking to improve patient health and eliminating cost drivers, as well as risks. Population health management (PHM) can too often focus on measuring quality in terms of task-based care. In some instances, this can significantly diminish the clinicians’ ability to decipher difficult medical situations and impact their ability to build strong relationships patients who have complex chronic care needs.
As the prevalence and associated costs of chronic diseases continue to grow, healthcare stakeholders, including payers, are focusing on performance and population health program (PHM) measures of chronic conditions for reimbursements and value-based incentives.
Provider groups taking on risk have initiated disease management (DM) programs for patients with common chronic diseases, and complex case management (CCM) programs for patients who experience critical or traumatic health events, or who have highly complex and high-acuity diagnoses. Core to both DM and CCM programs are requirements for care managers to address behavioral health problems or socioeconomic challenges. Effective care coordination programs have the capability to focus on building relationships with patients and primary care providers. This can allow provider groups and payers the ability to demonstrate improvement in preventive care and quality measures.