Harnessing the Power of Emerging Care Systems

At the 20th Annual Ambulatory Surgery Centers Conference in Chicago on Oct. 24, Fred Davis, MD, of Michigan Pain Consultants in Holland, discussed how emerging systems of care can grow a specialty practice.

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Dr. Davis is also a clinical assistant professor at Michigan State University in East Lansing and is affiliated with ProCare Research and ProCare Systems.

He detailed a collaborative partnership Michigan Pain Consultants and a local HMO engaged in over the past year to obtain value-based pain management care. The future of medicine is moving beyond using research data to deliver cost-effective care; it’s moving toward clinical practices based on tracked outcomes where the payers and the practice get to share in the costs and gains, he said.

Specialty centers will face new challenges as healthcare models evolve; these centers should strive to be at the table to develop the in-house payment methods that will affect them. Michigan Pain Consultants’ HMO partnership stemmed from a need to come up with long-term strategies for managing chronic disease treatment needs, he said.

“The strategic value in measuring clinical outcomes allows us to bring tools to the table that can be useful to the larger organizations we will integrate with,” he said. “It helps us get voice in the future.”

He recommends centers use a digital toolbox to improve care and track outcomes. Such tools can include a patient assessment matrix, clinical performance summaries and paid health assessments. Dr. Davis’ practice measures patient satisfaction and quality of life and then uses the data to inform decision making.

He predicts future trends for pain management and specialty practices will require physicians to move away from just taking care of the patients in the office that day toward looking at the needs of the entire patient population.

“In the future, we will move away from an episode of illness to be part of a continuum of care across the illness and managing the reoccurrences,” he said. “Our specialty practices have got to integrate with primary care. We cannot stand alone anymore. We must establish data-driven referral relationships that are quality and value driven.”

Pilot projects, such as the collaborative relationship he helped establish with the HMO, take great commitment and communication from both parties. It also requires tracking and collecting patient data in an appropriate way. Dr. Davis’ group used a cloud system with de-identified information in a color-coded spreadsheet.

After one year, the insurance company experienced a 43 percent reduction in the overall cost of care for the high-risk patients, and 51 percent of the patients experienced increased pain relief. The data showed 50 fewer emergency department visits. Based on real, effective data, the project was deemed a success and renewed for another year.

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