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Nielsen Survey Shows Gaps in How Patients Are Experiencing Accountable Care


Care Coordination Improving, Technology and 24/7 Access Not Widely Available, and Preventive Primary Care Critically Lacking

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WASHINGTON, D.C. (June 15, 2016) – A new Council of Accountable Physician Practices (CAPP)-sponsored Nielsen Strategic Health Perspectives survey released today reveals that only half of patients are experiencing the benefits of coordinated care and only about one-third have 24/7 access to care outside of the emergency department. The report also finds sluggish progress in the use of health information technology to connect doctors and patients, and that patients, including those who are obese and at risk for chronic illness, do not report receiving prevention counseling from their physicians.

The 2016 Nielsen Strategic Health Perspectives surveyed 30,007 U.S. consumers and 626 physicians. It is the second annual survey that CAPP sponsored to monitor the progress of meaningful healthcare delivery reform and the movement toward accountability.

“This survey is evidence of the failure of American healthcare to provide coordinated, technologically enabled, high-quality healthcare to the majority of people,” said Robert Pearl, M.D., Chairman of CAPP, and CEO of The Permanente Medical Group and the Mid-Atlantic Permanente Medical Group. “We know that CAPP members, all committed to the multi-specialty medical group model, are best positioned to deliver superior outcomes to the patients they treat. CAPP stands ready to help others improve their care delivery systems, and to work with policymakers to facilitate these changes. These findings reinforce CAPP’s long-held belief that patient-centered care models are critical to closing the gaps between what patients need and what they are currently receiving.”

The survey measured respondents’ experiences with the five patient benefits associated with effective accountable care: care team coordination, prevention, 24/7 access, evidence-based medicine, and patient and physician access to and use of robust information technology.

Data from the survey shows that:

  • Eighty-nine percent of primary care physicians say they often remind patients about preventive screenings, but only 14 percent of patients say they get these reminders. More than two-thirds of adult Americans are overweight or obese, yet only 5 percent of patients report that their physicians recommended a weight-loss program.
  • Only half of patients are experiencing physicians who better know their history, primarily due to the ability to share information through electronic medical records. However, patients with multiple chronic illnesses, who would most benefit from care coordination, receive only slightly more follow-ups and care management as everyone else.
  • Patients’ electronic engagement with physicians is increasing but still low, with 20 to 30 percent of the total surveyed reporting that they have various forms of digital access like online submission of medical questions, email or text reminders. Roughly 44 percent report access to online information, such as appointment scheduling, obtaining lab test results, or viewing information via portals. Older Americans are less likely to want to use digital technology for healthcare, which presents a challenge in fully leveraging this technology to improve care delivery to this population.
  • Only about one-third have 24/7 access to care through their physician’s office other than the emergency room.
  • Sixty-five percent of physicians report using evidence-based guidelines to help determine treatment, with 39 percent of patients recalling discussions on new treatment options.

The leaders of CAPP, a coalition of leading integrated multi-specialty medical groups and health systems across the U.S. have long been committed to accountable, physician-led, patient-centered care. CAPP Executive Director Laura Fegraus said, “Our survey found that while it is encouraging that the use of care teams and care coordination seem to be increasing, access and the effective use of technology still need improvement, and tactics that help to prevent illness are still woefully ineffective.”

patient report cardWhile these results show that delivery system reform is beginning to move in the right direction, the work is far from over. CAPP supports policy initiatives that can expedite performance in accountable care, including payment reform to support “system-ness” and better outcomes; more robust health information technologies to improve sharing of information among providers and easier access by consumers; and standardized quality measures in language consumers can understand.

For more information on the survey findings, click here.

These survey results were presented and discussed today at a joint forum presented by CAPP and the Bipartisan Policy Center: “Better Together Health: Patient Expectations and the Accountability Gap,” held at the Center for Total Health in Washington, D.C.


Registration Now Open for Better Together Health 2016

Featuring Sen. Johnny Isakson (R-GA), co-chair of the Senate Finance Committee Chronic Care Working Group.

By Laura Fegraus, Executive Director, Council of Accountable Physician Practices

CAPP has long been engaged in educating American consumers and policymakers about accountability in health care, the multi-specialty medical group model, and the need for robust delivery system reform. However, we continue to observe a persistent knowledge gap and low expectations surrounding the transformation in the care available to consumers in the post-ACA environment. Additionally, we are concerned that two important voices—the patient’s and the physician’s—are conspicuously absent in the national dialogue.

In 2015, CAPP launched the first of our Better Together Health events, a forum through which we hope inform the national dialogue on care delivery. (Highlights and the dedicated website from the first event in the series, Better Together: High Tech and High Touch, can be viewed here.)

This month, on June 15th, CAPP will host Better Together Health 2016 with the Bipartisan Policy Center at The Center for Total Health in Washington, DC. Titled “Patient Expectations and the Accountability Gap,” this event will present the results of CAPP’s 2016 Nielsen Strategic Health Perspectives consumer and physician survey; highlight chronic care patient stories that showcase how accountable care can improve care delivery and the patient experience; and feature a panel discussion on what is possible in chronic care management when clinicians collaborate effectively within a truly accountable health care system.

We are pleased that our keynote speaker will be Sen. Johnny Isakson (R-Ga), Co-chair of the Senate Finance Committee Chronic Care Working Group. We also welcome Dr. Leana Wen, Health Commissioner of the city of Baltimore; patient advocate Regina Holliday; Dr. Karen Cabell of Billings Clinic; and Dr. Marc Klau of the Southern California Permanente Medical Group. Ceci Connolly, CEO of the Alliance of Community Health Plans, will be our moderator for the day.

For those of you in the DC area on June 15, please join us! Others can watch a live-stream of our event. Just click here for more information about both the in-person and live-streaming registration.

I look forward to seeing you there!


CAPP Congratulates Kaiser Permanente’s New National School of Medicine

New Kaiser Permanente Medical School to Open in 2019

Recognizing that the practice of medicine in the 21st century is vastly different from the way previous generations of physicians have been trained, Kaiser Permanente and its medical groups have announced that the organization will open a new medical school in Southern California to educate future physicians. The Kaiser Permanente School of Medicine will design physician education to include how to provide health care outside of the traditional medical settings, work as multi-specialty teams to coordinate care, leverage modern technology, maximize teamwork and address the disparities in health outcomes that exist in America’s diverse communities.

“When fully realized, the school will enhance the health care provided nationwide and beyond as the newly graduated physicians bring to bear their training and knowledge wherever they choose to practice,” said Edward M. Ellison, MD, executive sponsor for the School of Medicine, and executive medical director, Southern California Permanente Medical Group. “This training will emphasize evidenced based medicine, systems of care, social determinants of health, technology, cultural competence, leadership, teamwork, and the wellbeing of both patient and physician.”

“If the American health care system is to improve, we need physicians and care providers who understand not only how to provide the most advanced medical care to patients, but also prevent disease in the first place, maximize patient safety and increase health outcomes for all,” said Robert Pearl, CEO of The Permanente Medical Group, and chair of the Council of Accountable Physician Practices. “Training the next generation of young physicians and developing physician leadership will be critical for the future health and well-being of our country. I am proud that Kaiser Permanente is leading the way.”

This new school is a natural extension of the work that Kaiser Permanente is already doing in physician training. Currently, more than 600 new physicians are completing their residency programs each year through Kaiser Permanente programs, and thousands more are learning from Permanente physicians through affiliated programs with major universities across the country.

In the release announcing this new venture, George Thibault, MD, president of the Josiah Macy Jr. Foundation—the only national foundation dedicated to improving public health by advancing the education and training of health professionals—said, “Medical education needs to change to keep pace with the changing healthcare delivery system and changing patient needs. Kaiser Permanente is in a position to make important contributions to these changes by bringing its vast experience with teamwork, coordinated care and technology to medical education.”
Scheduled to welcome its first class of students in the fall of 2019, the planning and establishment of the new school will be led by a multidisciplinary team of physician, health plan and operational leaders, including nationally recognized care quality leader, Christine K. Cassel, MD. Recruitment for the founding dean will begin in 2016.