Gaines said, “We allowed each group to pick one outreach tactic in the pilot/challenge period – including portal messages, electronic calls and calls from pharmacists and care managers. While all tactics were fairly effective, we found that outreach via the care managers was the most effective strategy, activating some 35 percent of unengaged patients. Having a pharmacist call these patients was the second most effective strategy.”
While having care coordinators make calls had the best results, they learned that it was not the most cost-effective strategy and was not using these professionals to the top of their license. After evaluating the challenge period results they piloted a ‘panel coordinator’ position that used a medical assistant to focus on engaging patients.
The results were impressive. At the beginning of the challenge period, 29 percent of patients were uncontrolled. After three months, they surpassed their goal of decreasing this number to 23.2 percent and reduced the uncontrolled patients to 19 percent. Next, they set a goal of 15 percent, which they have now maintained for three years.
The following year, six of their primary care practices became recognized in the top 20 percent of quality performance in the Blue Cross Blue Shield of Michigan incentive program.
Gaines concluded, “While it was initially hard to get providers to trust the data and use it to improve quality, today, it has become second nature and these practices have hardwired this approach to patient care.”
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