Top three patient care essentials

Patient care has to be personal, equitable, and accountable, said Griffin Myers, MD, co-founder and chief medical officer at Oak Street Health, in his June 8 presentation at America's Health Insurance Plans (AHIP) Institute & Expo 2017 Institute & Expo, in Austin, Texas

Oak Street Health operates a network of 20 primary-care centers in Illinois, Indiana, and Michigan. At these health centers, clinicians tailor care to the unique needs of people with Medicare. Its doctors see fewer patients, which means they have more face-time with patients-and that enables the network to understand its patients’ needs and develop comprehensive plans to treat those specific needs.

When Myers says care has to personal, what he means is clinicians need to spend more time with patients-and the care patients receive has to be evidence-based, while realizing that there’s no “one-size-fits-all approach,” he said.

Oak Street Health’s focus on caring for patients in underserved areas allows Myers and his team-he treats patients a half a day each week-to provide equitable care. “We provide care in neighborhoods that are traditionally underserved, and every patient gets the care that they deserve to get,” he said.

Finally, patient care has to be accountable, he said. “We hold ourselves to a very specific promise. When we talk about value-based care, that’s delivering outcomes that our patient cares about, that our patient values.”

What’s unique about Oak Street Health is it was “built from the ground up to be a value-based provider of primary care for adults on Medicare,” Myers told Managed Healthcare Executive (MHE). That means its primary-care network is a “full-risk, full-value partner” with seven different health plans across the country.

“If we don’t deliver measurably better care for our patients, then we will go out of business. Now the good news is that we have delivered that impact, and the story for our patients is a good one,” he told MHE.

For example, he told MHE about one of Oak Street Health’s patients: A 92-year-old woman who lives alone in Bronzeville, Illinois. The elderly woman’s daughter lives upstairs, so his patient has nearby family support. After this patient-she lives with congestive heart failure, vascular disease, diabetes, and moderate dementia-arrived at the nearby emergency room with a fever, Myers and his team swung into action, he said.

The care team communicated directly with the patient’s emergency room doctor and helped their patient navigate the discharge process and receive follow-up care, which included a check-up four days after her emergency room visit.

He contrasts the experience of that patient with a 65-year-old homeless man who was trying to get into a rehab facility to recover from substance abuse. The rehab facility wouldn’t admit Myers’ patient because he had a cough, so the patient came for a same-day appointment at Oak Street Health, where he was able to get a prescription to treat the cough and Myer’s cellphone number. He was subsequently admitted into the rehab program.

The key difference between these two patients is the amount of family or community support they have, Myers told MHE.

Oak Street Health is able to accommodate patients with same-day appointments because of its team-based approach to care, added Myers. For example, if a patient needs to see him immediately, the patient he’s currently seeing can have their blood work done by another member of the care team.

Myers’ co-presenter, H. Scott Sarran, MD, divisional senior vice president and chief medical officer of government programs at Health Care Services Corporation, told MHE, “In this competitive world, health plans increasingly rely on aligned, long-term, win-win performing providers in order to succeed, hence the importance of value-based arrangements in Medicare Advantage.

“These often involve some elements of capitation and/or delegation in Medicare Advantage HMO products; in PPO products, these more often have features of ACOs and/or pay-for-performance,” he added.