Interview Topic: Enhancing Care Delivery by Deepening Patient-Provider Relationships and Developing Community Partnerships

Michael Ruiz de Somocurcio

Vice President
Payer and Provider Collaboration at Regional Cancer Care Associates LLC
Greater New York City Area

In an environment where providers are paid based on schedules packed with short appointments, how do you develop the relationship that is so important to care for the whole person?

Although our physicians treat cancer, many of our patients have other co-morbid conditions that can impact their treatment. As value-based care and the concept of population health gains more traction, it becomes important that our physicians work closely with other providers/hospitals to ensure our patients receive appropriate treatment and coordinated care. It’s also imperative that patients and caregivers have a greater voice in the care provided so they fully understand their treatment options. Regional Cancer Care Associates (RCCA) operates 29 practices in New Jersey, Connecticut, Maryland, and Washington, D.C. and is a member of the New Jersey Health Care Quality Institute. RCCA is one of 195 practices nationally that are part of a CMS innovation program called the Oncology Care Model (OCM). The main principle of OCM and our other value based programs is providing patient centered care. RCCA has pushed all of our chips in when it relates to these models as we have been an early adopter. Not only does it require coordination around the care provided, but there has been an added focus on psycho-social needs and financial counseling, which have large impacts on patients as well.
If you could wave a magic wand to achieve instant adoption and effective use, what one real model, tool or resource would you recommend for practices in order to achieve the objective of deeper patient relationships?

I would love to see a technologically integrated system where EMR’s all spoke with each other so that if a patient is in the hospital or ER, that we would be notified in real time. A system that can monitor our high-risk patients at home and where our care team is notified when interventions may be required. Lastly, where patients can easily download their information and we can push education and notifications in an intuitive enough way so that patient engagement can increase. All of these things would then be available in a cohesive and integrated way. We are not that far off with this concept as there has been a lot of progress with these things, but they are mostly done in silos and not integrated. A truly efficient system would have this integration.

It has been said that lack of time and deep relationships with patients are the missing ingredients that lead to provider burnout. What are your thoughts and how do you overcome that?

The practice of medicine has become more and more administrative. Studies show that 17% of a physicians’ time is spent on the bureaucracy of healthcare: this includes billing and collections, preauthorizations, negotiating contracts and quality reporting. With the advent of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and value-based care, the Center for Medicare & Medicaid Services (CMS) and health plans are requiring more of physicians. Lack of performance in these models can negatively impact physician revenue as well. Does this mean that patients are actually getting better care as a result? These tasks directly take time away from patient care. Physicians will have to do more, but it is critically important that changes occur as efficiently as possible while utilizing existing workflows. Not all tasks require a physician, however. RCCA has hired staff to support them both from a clinical and business standpoint. We have nurse navigators to help coordinate patient care, clinical documentation specialists that support our EMR and quality capture and reporting, and data analysts and informatics folks to compile the data we receive so we can distribute across our organization.

What are key strategies that you recommend to overcome provider burnout?

As I mentioned previously, having folks work at the top of their licenses to help support our physicians is critical. Information sharing is key as well – RCCA receives a lot of information from Medicare and our health plan partners. We are lucky to have active physician leadership in our organization who have created a great culture. Providing them information and data as to why we are in certain contracts or agreements and how each are performing individually shows them the result of these interventions. As the results show better patient experiences and outcomes, I think it gives them a new-found excitement as to the potential of what can be accomplished. It’s a journey, but a highly rewarding one.