Why proactive care management matters for every practice

At Pickens County Primary Care in rural Alabama, Julia Boothe, MD, knew traditional face-to-face visits weren’t enough to keep patients healthy. By adopting a continual care model, her team now provides support between visits, preventing avoidable emergency room trips and improving quality measures.

“Our department is actually a revenue generator for the whole clinic,” Boothe said, noting the program sustains itself financially while supporting better outcomes.

Zach Mortensen, MBA, vice president of Solutions at Phamily, said scalable tools and training make these programs practical for any size practice. “These programs allow practices to fund that transformation to value while taking better care of more of their patients today,” he said.

With payers pushing value-based care, Boothe said now is the time for practices to act: “This is doable throughout the clinics.”

For a deeper discussion on why proactive care management is vital for practice sustainability, watch the recorded session here.

Physicians Practice: What led you to make proactive care management a priority at Pickens County Primary Care?

Julia Boothe, MD: Well, we needed to solve the question of, how do we measure and follow everyone's quality and make sure we're hitting all the marks? And having care throughout the times with the patients just wasn't a way to do it. So, there wasn't enough time in the face-to-face visits, and so adding a continual care model has helped us to be successful with that. So that's how we got involved.

Physicians Practice: What has wraparound support meant for your patients?

JB: I think it's just answering questions, even when we don't know that they're being asked. Just being available. Having a way for patients to communicate with us, whether that's by phone, whether it's by portal, whether it's by text, it just allows them a lot of different options to reach their care manager nurse, who can then get in touch with the clinician as quickly as possible, so that we, you know, hopefully, prevent some unnecessary emergency room visits, unnecessary admissions, things that we can handle on the front end.

Physicians Practice: Can care management programs really drive revenue?

JB: They can. Our department is actually a revenue generator for the whole clinic. There have been months, you know, over the last seven years that we've been doing this, where maybe that wasn't the case, but they do stand alone, and they actually support the clinic revenue.

Physicians Practice: Why is now the right time for practices to consider scaling proactive care management programs?

Julia Boothe, MD: Well, value-based care is here to stay, and all of the payers are pushing more and more to that. And so, you have to have a way to take care of people outside of just the fee for service model, which we were used to, and we're trained on. And I think that's how you think of it in the old days where you hung your shingle, it's just, you know, fee for service. But it's different now. And so, to be successful in value-based care, you have to have a way to take care of people throughout the week.

Physicians Practice: So, what do you want attendees to take away from your MGMA Leaders session?

JB: I think the main thing is, any practice can do this. I'm in a tiny, little rural town in Alabama. It's a very underserved town. I have a traditional fee for service practice. We're not a rural health clinic. We're not an FQHC. These models also work in those as I do have school clinics that are rural health clinics, but I think that's the main thing is, this is doable throughout the clinics.

Physicians Practice: How does Phamily support practices and make proactive care management scalable and sustainable?

Zach Mortensen, MBA: Great question. Our support consists of our software, our platform that helps care managers take care of many more patients than they could otherwise. We have a team of services professionals that manage our implementation and training and help practices navigate that transformation, that change management, in addition to automating some of the back-office work to enroll patients and get them consented to these sorts of things, and we're increasingly taking on more of that frontline clinical support in partnership with certain customers.

Physicians Practice: Why should health care leaders be paying close attention to this topic?

ZM: This is an absolutely relevant topic, because I think it helps each organization sort of move forward in that journey to value the value based incentives are there and everybody's at their own place, but those take a while to mature, and these programs, the site that we've implemented with Dr booth and her clinic, allow practices to help fund the that transformation, fund that journey, while taking better care of more of their patients today.