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Better Quality, More Money. Right Now
In 60 days, Prevea Health made an extra $1 million in net revenue. How? Not with a fancy ancillary service or new payment system. It just started using software to actively recall patients behind in their care. For this 180-physiciangroup in Green Bay, Wisc., that meant 7,758 existing patients called in for preventive and follow-up care that they probably would not have otherwise received, according to hospitalist Ashok Rai, the multispecialty group’s chief medical officer.
In other words, Prevea made money by improving quality. Its physicians took better care of patients, and the practice saw more revenue as a result. We’ve been hearing a lot lately about the idea of paying primary care physicians extra to provide preventive services more comprehensively. Medicare’s flawed pay-for-performance program is one example. The “medical home” concept promoted by several professional associations is another. But Prevea’s experience begs a question:
Do you really need to wait around for such programs to develop in order to start getting paid more to do better?
Rai doesn’t think so. “We consider we have all the aspects of a medical home already, and we are rewarded for that without remuneration
from the medical home [demonstration project],” he says.
And the pay-for-performance programs offered by Medicare and other payers are not necessarily the answer, either. Most physicians already give fine care, Rai argues. The challenge is getting patients who need care in front of good physicians in the first place, he says, not marking off codes to show that
physicians provided it.