How to Get Better Care with Lower Costs? See the Person, Not the Patient

This article discusses the importance of interacting with individuals as “people” not “patients” in order to provide a more all-inclusive type of care. This is especially important for older adults, who experience chronic health problems, functional limitations, physical challenges, and a deeper reliance on social support. Programs such as disease state management fail to recognize a person as a whole, with many other factors affecting their health and outcomes than just one specific disease itself.

The process of a person-centered care program means putting people in charge of their own health. It involves taking time to identify their personal needs, preferences, and values, consulting familial support if needed. When this information is combined with a health and functioning assessment, the person is able to shape their own personal goals rather than those based simply on medically-defined clinical outcomes. This process allows for the development of a care plan and implementation strategy individual for each person. By allowing each person to identify their own personal goals, and providing the needed support for it to happen, they will be much more motivated and successful in striving for those goals. This process has been developed with and supported by the American Geriatrics Society (AGS).

Three critical indicators of quality person-centered care for older adults are high functional quality of life with minimal intervention, healthcare providers acting in an efficient, convenient manner, and ability to easily navigate the care system as needed. The degree or extent of each of these indicators will vary for each person based on individual functional abilities, family support, and more.

There are several models that embrace this paradigm. They have been able to demonstrate that there is an opportunity for better care for high-need older adults at lower costs. These cost savings may not seem favorable initially when considered on a short-term small scale. This is the case with remote mail-order pharmacies for prescription refills rather than direct pharmacy interaction. However, Washington University’s care management program under the CMS Medicare Coordinated Care Demonstration Pilot is working on proving the long-term benefit of face-to-face interaction over mail-order pharmacy experience for individuals in the older adult population. Considering the points made in this article and the person-centered care approach that is outlined, do you think the emphasis we are seeing currently in mail-order pharmacy for many Medicare patients will be short-lived

Westphal, E., Alkema, G., Seidel, R., Chernof, B. How to get better care with lower costs? See the person, not the patient. J Am Geriatr Soc. 2016; 64:19-21. Doi: 10.1111/jgs.13867