Physican Talking Points

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Physician Talking Points

Why do physicians recognize the need for home care,

yet question it so readily?

The HCAC PR Project Team researched this puzzle from a physician’s perspective and discovered

some common issues and frustrations. The result is this template, the fourth to be produced by the project team. This template provides you with a communication tool that your agency can use to discuss ways to ease the minds of physicians about home care. The approach of each agency will vary to meet the needs of the agency’s own situation, however, these points of discussion – both the positives and the frustrations – should be applicable to any agency.

A most important finding was that most physicians feel that the home environment is conducive to the healing process of a patient, and that home care has a strong position in the health care delivery system. They realize that patient education provided in the home takes the burden off the physician, the office and hospital staff, while increasing the potential for better retention of learning by the patient and family members. Many physicians also acknowledge home care’s role in the prevention of co-morbidity. And they look toward home care as a specific cost-containment solution through decreased in-patient utilization.

However, physicians also express some frustrations about home care. Here are their major issues, their specific frustrations, and some talking points you might cover with them. -- PR Project Team, HCAC Communications/Technology Council

Issue	MD Frustrations	Point of Discussion
Communication	1. Standardized paperwork - not personalized for each patient and too much information - meets regulations, but not the need of the physician 2. Multiple calls from caregivers for same patient 3. Patient status reports not based on physician needs	1. Be brief, clear and provide meaningful information in your communication with a physician. Consider using new forms such as a summary sheet stapled to the top of a 485 Plan of Care which focus on the top three problems. 2. Designate a primary caregiver to coordinate communication with physician and/or establish internal communication protocols to respond to physician calls. Such protocols might include advance notification to receptionists when expecting a physician call, or appointing in-house person(s) to coordinate return calls from physicians. 3. Recognize and address the need for continuing collaboration. The more you know a physician’s desires, the more comfortable he/she will be to work with you. Develop communication parameters for each physician determining what information is urgent and what isn’t.
Reimbursement	1. Administrative time for paperwork and phone calls 2. Fear of over-utilization (i.e., fraud and abuse)	1. Be aware of how cumbersome this issue is to doctors and their office staff · Educate physicians about Medicare’s reimbursement provision for Home Care Oversight (billable in 30 minute increments). · Develop a 2-part NCR Communication Tracking Log for each patient for the chart and the physician billing staff where the physician can log any time spent on calls or reviewing and signing paperwork associated with a Medicare patient. 2. Build a good rapport with a physician and office staff by · Using case studies to present problems from a patient’s perspective and show how home care interventions helped the situation · Communicating with physicians that care plans are designed to focus on the problem and provide measurable outcomes. · Finding out who controls the referral process and keeping in contact with that person. · Sending thank you notes to physician offices after providing care to a patient. · Creating a profile for each medical practice which includes protocols about when faxes and phone calls are appropriate. · Providing resource information. Such information can include how patients can benefit from private duty nursing services when insurance coverage is limited.
Liability	1. Need for credible evaluation of agency 2. Directing a nominally-known entity and its staff 3. Insurance Utilization Managers (dominated by nurses) questioning physician’s competency on orders	1. Colorado is a highly competitive marketplace. Make sure your verbal and written sales pitches address such things as · compliance programs · length of service in the community · references · criminal background checks/bonding 2. Again, ongoing relationship-building is key. The more a physician and the office staff know representatives from your agency, the more they will be willing to continue working with you. When developing a new relationship with a physician, tenacity is critical. It often takes several visits to an office for staff members to develop a rapport. 3. Inform physicians that your home health case managers are physician and patient advocates.
Outcomes	1. Defining “quality of care”	1. Physicians are scientifically-trained and therefore require measurable data that equates to quality performance. Make physicians aware of any critical pathways you have in place with defined outcomes. Consider measuring / promoting the following: · hospital readmission rates · patient satisfaction surveys · success stories
Continuity of Care	1. Full service agency 2. Case conferencing 3. Caregiver skill level	1. Physicians want the ease of coordinated care with one phone call. It doesn’t matter if you own or contract out for services not provided by your agency. 2. Consider partnering with your top referring physicians by assigning caregivers/account representatives to establish ongoing rapport with the office staff and be a part of case conferencing. 3. Promote your competency/continuing education programs.

Issue

MD Frustrations

Point of Discussion

Communication

1. Standardized paperwork - not personalized for each patient and too much information - meets regulations, but not the need of the physician

2. Multiple calls from caregivers for same patient

3. Patient status reports not based on physician needs

1. Be brief, clear and provide meaningful information in your communication with a physician. Consider using new forms such as a summary sheet stapled to the top of a 485 Plan of Care which focus on the top three problems.

2. Designate a primary caregiver to coordinate communication with physician and/or establish internal communication protocols to respond to physician calls. Such protocols might include advance notification to receptionists when expecting a physician call, or appointing in-house person(s) to coordinate return calls from physicians.

3. Recognize and address the need for continuing collaboration. The more you know a physician’s desires, the more comfortable he/she will be to work with you. Develop communication parameters for each physician determining what information is urgent and what isn’t.

Reimbursement

1. Administrative time for paperwork and phone calls

2. Fear of over-utilization (i.e., fraud and abuse)

1. Be aware of how cumbersome this issue is to doctors and their office staff

· Educate physicians about Medicare’s reimbursement provision for Home Care Oversight (billable in 30 minute increments).

· Develop a 2-part NCR Communication Tracking Log for each patient for the chart and the physician billing staff where the physician can log any time spent on calls or reviewing and signing paperwork associated with a Medicare patient.

2. Build a good rapport with a physician and office staff by

· Using case studies to present problems from a patient’s perspective and show how home care interventions helped the situation

· Communicating with physicians that care plans are designed to focus on the problem and provide measurable outcomes.

· Finding out who controls the referral process and keeping in contact with that person.

· Sending thank you notes to physician offices after providing care to a patient.

· Creating a profile for each medical practice which includes protocols about when faxes and phone calls are appropriate.

· Providing resource information. Such information can include how patients can benefit from private duty nursing services when insurance coverage is limited.

Liability

1. Need for credible evaluation of agency

2. Directing a nominally-known entity and its staff

3. Insurance Utilization Managers (dominated by nurses) questioning physician’s competency on orders

1. Colorado is a highly competitive marketplace. Make sure your verbal and written sales pitches address such things as

· compliance programs

· length of service in the community

· references

· criminal background checks/bonding

2. Again, ongoing relationship-building is key. The more a physician and the office staff know representatives from your agency, the more they will be willing to continue working with you. When developing a new relationship with a physician, tenacity is critical. It often takes several visits to an office for staff members to develop a rapport.

3. Inform physicians that your home health case managers are physician and patient advocates.

Outcomes

1. Defining “quality of care”

1. Physicians are scientifically-trained and therefore require measurable data that equates to quality performance. Make physicians aware of any critical pathways you have in place with defined outcomes. Consider measuring / promoting the following:

· hospital readmission rates

· patient satisfaction surveys

· success stories

Continuity of Care

1. Full service agency

2. Case conferencing

3. Caregiver skill level

1. Physicians want the ease of coordinated care with one phone call. It doesn’t matter if you own or contract out for services not provided by your agency.

2. Consider partnering with your top referring physicians by assigning caregivers/account representatives to establish ongoing rapport with the office staff and be a part of case conferencing.

3. Promote your competency/continuing education programs.

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