Care Transformation Center Blog

(Nearly) everyone is managing well patients wrong

The other day, it came to me. In American health care today, nearly everyone is managing well patients wrong.

Inspired by Hamza Hasan’s excellent post last week, which laid out the three types of patients central to population health success, I got to thinking: if you’re a health system, you ought to have two, and only two, objectives relating to well patients.

Your #1 objective: Offer convenient access

You need to give well patients convenient access to primary care services, so that when they do need your help, they know exactly where to go and what to do to engage the health system. These days, the state of the art is electronic access to health care, through a patient portal.

One pioneering health system that created a top-notch primary care patient web portal is now seeing nearly half their PCP "visits" come through that portal: prescription refills, simple medical problems, and questions for physicians. And, by all accounts, patients are delighted with the experience.

Beyond the web-based experience, innovative providers are offering better in-person access through extended clinic hours, "retail clinic" locations, and flexible scheduling options.

Today, most health systems, even those with large employed primary care networks, have not invested in convenience as much as they should to stay competitive. Best-in-class organizations are setting the bar at access within 24 hrs (or better) through combination of office and portal.

Your #2 objective: Foster loyalty

Anything you’re doing with well patients that’s not about facilitating access should be about making your services valuable to them, ensuring you remain top-of mind as their health care provider of choice (even when you’re doing nothing).

This is especially true for health systems starting to take on financial risk for the health of populations. Health systems that fail to keep well patients on their rolls could end up with a disproportionately unhealthy population—and be subject to financial losses.

What keeps healthy patients engaged?

Of course, convenient access is part of the equation. But beyond access, we’re seeing primary care practices starting to compete on the quality of their customer service, the breadth of their wellness offerings, and even their cost—much like any other retail business.

  • Lisa BielamowiczAre you ready to compete with Walmart?
    One-third of your patients shop at Walmart every week—what if they could get care there, too? Watch the video to learn why you need to shift your growth strategy now.

The end of the annual physical?

If you prioritize access and loyalty above all else, you might rethink how you’ve traditionally managed healthy patients. And indeed, high-performing population health managers are starting to reconsider the most cherished elements of well patient management, including the annual primary care visits.

Yes, we need to make sure well patients are continuing to do well. However, from a resource effectiveness perspective, the annual PCP check-up is neither necessary nor desired by patients, at least for the healthy well below Medicare age.

We’re starting to see clinical guidelines and the popular press latch on to this idea. A biannual well-patient visit may be more than adequate, if you supplement it with electronic access and other tools.

It’s certainly a more cost-effective and scalable way to manage a population of well patients.

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Lisa BielamowiczAs the Chief Medical Officer for the Advisory Board's Research and Insights division, Lisa leads research in hospital-physician alignment, care transformation, and clinical innovation.

See all of Lisa's blog posts.

What You Can (and Should) Do for Healthy Patients

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Meet the Author

Lisa Bielamowicz
Executive Director and CMO
Health Care Advisory Board

See all of Lisa's blog posts and stay tuned for updates.