Measuring the New Doctor “Visit”

Team-based Care Requires Team-based Metrics

 By Jen Coury

The old adage goes, “You get what you pay for.” But what are you paying a health care provider for if it’s not a doctor’s visit? The Alternative Payment Model (APM) has shifted payments away from the number of clinic visits with a doctor and towards a per-patient monthly rate. This means that somehow the health care systems in the pilot need to demonstrate what care they are delivering. But measuring population-based health management is a lot trickier than counting how many times a patient walks through the door of the clinic.

What defines success? The State, Oregon Primary Care Association, and the health care systems taking part in the APM Pilot have been working together to answer this question. The ideal health care scenario is to deliver the right care, at the right time, to the right person. They are working towards a metric that captures the accountability of a health care provider.

Ultimately, the State will want to pay primarily for health outcomes, but that’s a long way from now. For example, if you think of a health care system as managing the health of a population (in the new model), then one measure might be what percent of the population is the provider in touch with. Meanwhile, we have to pay health providers while moving towards this future ideal model of care. Continue reading Measuring the New Doctor “Visit”


A Conference Inspired Look at the Rural Primary Care System

By Glenn Kautz, MPH

In October 2014, I attended the Oregon Rural Health Conference in Bend, OR. It was my third time attending the conference and I found a familiar forward-thinking amalgam of healthcare leaders from all corners of Oregon. Most conferences exude some level of enthusiasm for networking and new ideas, along with a feverish craze for self-serve coffee. However, this is always a unique conference experience for me. In addition to the usual conference tones, there is an extra helping of camaraderie, shared purpose and family that is inspiring for a medical student such as myself.

Presentations covered the areas of Alternative Payment Models (APMs), workforce issues, and data-driven process improvement approaches. While these topics are interesting in-and-of-themselves, looking at them through a rural lens also spurred my curiosity for how rural and underserved are defined, and how this affects the structure of the primary care system. Throughout the conference, I repeatedly heard the term, “Rural Health Clinic” (RHC), and wondered what they were and how they compare to Federally Qualified Health Centers (FQHCs).

Next year, as an Oregon Rural Scholar, I will spend 12 weeks in a clinical rotation at a family medicine clinic in a rural area of our state. I am honored to have such an opportunity, and I am incredibly excited to learn more about healthcare issues in rural settings by listening to patients, working with providers and getting to know the community. For now, however, I want to understand what rural means through healthcare policy and research lenses.

Continue reading A Conference Inspired Look at the Rural Primary Care System