From Dr. Tom's Desk
For organizations that actually risk-share, who actually train and mentor their clinicians, asking their PCPs to care for too many patients is the greatest barrier to success.
When considering cost control, nothing beats the influence a personal relationship between patient and doctor can generate. But even with the leverage that technology tools provide, it’s impossible for a PCP to have an effective relationship with thousands of patients.
A ninja PCP, an elite top performer (a.k.a. one who has been mentored by me) can care for as many as 1000 patients.
But a PCP who’s poorly trained or inexperienced can often only manage a panel of 100 and grow from there---that is, if they don’t get discouraged and quit first.
As organizations expand into the risk-sharing space, it’s not uncommon to see them suddenly dump panels of hundreds or thousands of patients onto primes to manage---and to do so with little preparation.
The first thing I tell them is to start slow. I advise them to segregate out 100 or so MA patients for each of their PCPs and share risk only on that subset of patients. Then, as their expertise grows, increase the number of their risk sharing patients. Even if the PCP has a thousand patients assigned to them through the insurer, I advise the organization to take the financial responsibility on for most of them themselves and start the PCP off with a more manageable number.
It’s a great way to ramp up---and create a stable of ninjas of your very own.
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