Posted by: Meg Storm
Date: March 8, 2023
At one time, patients only went to their family doctor when they were sick. As health care has taken on a broader scope to include preventive medicine, specialist care, and population health management, the role of the Primary Care Physician/Provider (PCP) has matured into an “air traffic controller” for a patient’s well-being. PCPs not only care for a patient’s acute and chronic conditions but help them navigate an increasingly complex health care system. Employers concerned about rising employee health care costs can make a difference by understanding and encouraging their employees to choose a PCP.
“The prevention side of health is so essential to keeping ourselves from becoming chronically sick in the future,” says Carol Michaels, MPH, FACHE, MCHES,® Administrator, Care Coordination at Populytics. Prevention includes staying up on immunizations and getting age-appropriate screenings as well as maintaining a healthy weight, exercising, and getting enough sleep. “Developing a relationship with a provider that you feel you can go to and trust is key,” she says, “as well as being essential to comprehensive, effective care.”
Michaels points out that when people establish a relationship with a primary care doctor, they have a baseline for when they become ill. Not only that, but they gain an in-depth look into their current and potentially future state of health.
Through electronic medical records, the primary care doctor has access to a patient’s full medical history. Once a patient is attributed to a PCP through his or her insurance carrier, the PCP will also have access to insurance claims. When these two sources of information are combined and interpreted through data analytics, the integrity of the view is multiplied. The doctor then has immense insight on the patient’s gaps in care, health and lifestyle trends, opportunities for improvement, and next steps in their plan of care.
“For employers interested in lowering health care expenses, looking at whether your employees are aligned with a primary care physician is a step toward improving workforce health and more efficient health care spending.”
Research published by the Journal of Health Affairs notes that patients associated with a PCP have better management of chronic diseases, a higher level of satisfaction about their care, and lower overall costs. This is possible because of the collaboration inherent in the PCP-patient relationship. This relationship encompasses enhanced communication between provider and patient, comprehensive information, and close interaction with other providers for resources and support.
In today’s world, increasingly PCPs do not practice alone. Often, they are aligned with a health system as many are in our region through Lehigh Valley Health Network (LVHN). They can collaborate with a multidisciplinary community of other clinicians, including physicians, nurses, technicians, pharmacists, and social workers, to help determine and provide the proper “total” care for each patient.
LVHN has an added advantage since its affiliated clinicians work together with health care analytics provided by its subsidiary Populytics. In addition, there exists a full suite of well-being services through its corporate wellness and behavioral health divisions. Direct health care contracting is also available for employers. All these capabilities combined result in more connected, more comprehensive care with far less complexity than with providers who are not integrated in this manner.
Employers are the largest purchaser of health care in the United States, and often, pay a premium for what can turn out to be high-cost, lower-value care. As a result, today’s employers are dealing with, across the board, approximately 45 million employee sick days per year.*
Employers would benefit from promoting PCPs and their benefits among their employee population – since this is where good health care truly starts. As we have seen, the PCP relationship encompasses the fundamental elements necessary for creating change and may ultimately lower costs. These elements include disease prevention, identifying health conditions early, managing chronic conditions, educating, utilizing data, and providing a compassionate, caring partner.
Four things employers can do: