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Matt Lambert, MD, is a practicing emergency medicine clinician and the Chief Medical Officer at Curation Health. He has more than 20 years of experience as a clinician, CMIO, and change leader in value-based care — and is also the author of two healthcare books: Unrest Insured and Close to Change: Perspectives on Change and Healthcare for a Doctor, a Town, and a Country.
How do we guide the next generation of clinicians to prioritize value over volume?
As providers and payers invest in the move from volume to value, they are facing the reality that clinicians are lacking when it comes to training, education, and technology specific to enabling value-based care over fee-for-service.
In order to succeed in this transition, practicing clinicians and emerging residents need hands-on support and investment to evolve, fast.
While there has been some discussion on specific ways providers and payers can best support clinicians in this care evolution today—such as offering them tools that are purpose-built for value-based care (aka, not the electronic health record) and even incentivizing these changes—the same cannot be said for clinicians in training. Similar to how we adopted E/M documentation during my own training all those years ago, upfront investment by systems and payers now can help prepare the next generation of clinicians to make value-driven care a reality.
As we approach graduation season for colleges and schools across the country, and inspired by my nephew’s recent graduation from pharmacy school, I have had the opportunity to reflect on a few specific areas where future clinicians can focus to ensure they are prepared to succeed in the next era of healthcare.
First, rethink how you choose a residency program. While decisions specific to the residency match have always been difficult, they are becoming even more so today. Knowing that most academic institutions operate primarily in a fee-for-service world, prospective residents should consider how much training they might receive in value-driven best practices from their program.
Another area of focus for residents looking to better practice value-driven care is training in virtual care. Understanding and embracing rapidly evolving virtual care models is mission critical considering the increased role that telehealth will play in outpatient care. Inpatient care will always be a crucial part of delivery, but taking care out of the hospital and to the patient is a trend to understand and prioritize.
While many skill sets learned during residency apply to all models of care, there are areas of expertise that must be perfected specifically for virtual patient care like how to build patient trust and credibility when not face to face. Knowing the impact that residency training has on our practice patterns, getting smart on optimizing the patient care experience in a virtual environment is a skill best learned early on. Emerging clinicians who understand the nuances between in-person and virtual patient care will be well equipped to practice anytime, anywhere. We can expect the demand for these skills to grow over time with the evolving expectations of patients.
Lastly, residents need to double down on learning clinical documentation and coding best practices that align with value-based care. Clinical documentation is increasingly becoming a team sport involving clinicians, CDI specialists, and coders. Along with new information-blocking and open notes regulations, patients and payers are part of the team; like any team sport, success is rooted in the team’s ability to communicate and work together. As providers and payers transition to a value or subscription revenue model, they must ensure that they are arming their clinicians with the tools, coaching, and support to fine-tune this new collaborative documentation practice. Doing so will improve patient outcomes and ensure organizations are appropriately reimbursed for the quality and complexity of care their clinicians provide to patients.
Success in value-based care isn’t possible without the leadership and support of clinicians. The providers and payers that invest now in collaboration and preparation for clinicians and residents related to value-based care will be the organizations poised to lead and define the next generation of patient care.