Does treating patients with dignity, affording them autonomy, and personalizing care really save hospitals money? It is well documented in peer-reviewed literature that patient (and person)-centered actions and experiences result in positive benefits to patient satisfaction, treatment adherence, health outcomes (hospital readmissions, emergency room utilization, physiological status, etc). However, linking these positive health and experiential impacts on cost has been more difficult to demonstrate because of the following:
- Defining and authentically measuring patient-centeredness– different organizations define patient-centeredness differently, resulting in lack of clarity and making it difficult to replicate and scale successful innovations across systems.
- Lack of formal education, training, and measurement for staff that enables deeper personal understandings of patient-centered values and ethics.
- Poor patient health literacy and involvement in co-producing care–organizations miss opportunities to engage with patients and involve them in process improvement efforts to understand the system of care from their viewpoint.
- Defining success across the care continuum in different geographic and cultural settings.
Despite this, there is growing evidence nationally and internationally that builds the case - patient (and person)-centered actions are cost-effective. According to Horizon Blue Cross Blue Shield of New Jersey, “Members receiving care from a doctor who participates in a patient-centered program are scoring higher on quality care metrics - at a cost that is 9% lower than those members at a traditional doctor practice.” A study conducted by Horizon also revealed those same members were 6% more likely to be able to manage their diabetes, 7% more likely to control their cholesterol and 8% more likely to be screened for colorectal cancer. Additionally, the study found an 8% reduction in hospital readmissions and 5% reduction in emergency room utilization.
A study conducted by Stewart, Ryan & Bodea and published in Healthcare Policy, utilized the Patient Perception of Patient-Centeredness (PPPC) questionnaire to gauge how patient-centered practice translated to cost savings on diagnostic testing. The study of 311 family practice patients revealed the more patient-centered the visit, the less the cost for diagnostic testing in the two-month follow up period. Patients who reported first quartile patient-centeredness scores resulted in a mean diagnostic cost of $11.46 versus $29.48 for patients who reported fourth quartile scores, an average increase of 157% in costs. The authors suggest that one reason for this astonishing increase was a break of trust between provider and patient which resulted in excessive testing to clarify confusion or resolve conflict.
Evidence indicates that patient-centered care not only provides improved clinical outcomes, benefits to trust, and communication, but also yields more efficient and value-driven care. However, to scale the benefits of person-centered practices, education for both clinicians and patients, definition, measurement, and coordination of person-centered care throughout, complex care pathways need to be well-defined. goShadow expands the idea of patient-centered care to the entire care team through application of the person-centered value system, where both patients and front-line staff come together to co-design and co-produce innovative care pathways that provide clinical excellence, human-centered design, person-centeredness, continuous training, and process improvement for all stakeholders in any care experience. Partners have achieved and sustained Center of Excellence designation, less than 1% staff turnover, leading clinical outcomes, and patient-reported measures.
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Patient-centered care continues to deliver on promise of better quality care at a lower cost. Primary Care Collaborative. (2022, October 6). Retrieved August 12, 2022, from https://www.pcpcc.org/resource/patient-centered-care-continues-deliver-promise-better-quality-care-lower-cost
Stewart, M., Ryan, B., & Bodea, C. (2011). Is patient-centred care associated with lower diagnostic costs? Healthcare Policy | Politiques De Santé, 6(4), 27–31. https://doi.org/10.12927/hcpol.2011.22393
The state of play in person-centred care - The Health Policy Partnership. (n.d.). Retrieved August 12, 2022, from https://www.healthpolicypartnership.com/app/uploads/The-state-of-play-in-person-centred-care-summary.pdf
August 14, 2022