How physicians are rethinking care delivery

AMA Wire
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The way care is delivered can have drastic effects on patients’ health, even in the treatment of the same illness. One physician shares her experience in the differences between fee-for-service and value-based care, and how these differences have directly affected her patients’ health outcomes.

In an AMA “Innovations in Medicine” talk—a brief, informal presentation in the style of TED Talks—Grace Terrell, MD, explains how she and her colleagues at Cornerstone Health Care in High Point, North Carolina, decided to change everything about how they practice medicine.

“As successful as we’ve been in the fee-for-service world … it was unsustainable,” Dr. Terrell, who is president and CEO of the group practice, said.

She used two stories of two patients—both elderly women with the same illness—and how their health outcomes differed based on which system of care delivery they used. The health of the patient who underwent treatment in the traditional, fee-for-service model of care only grew worse. At the same time, her treatment costs totaled more than $200,000. The other patient, who was treated in a value-based payment model, saw immediate health improvement and a bill of less than $1,000.

Dr. Terrell’s group of 180 physician owners and 360 health care professionals who banded together to transform care delivery had to make some important, upfront changes in order to see results, she said. That included investing in new ideas, such as patient care advocates, team-based care and a robust information infrastructure. They also had to change the way they were paid, and now all of the group’s contracts with payers are value-based.

“It’s not a miracle,” Dr. Terrell said. “We are very average doctors in High Point, North Carolina. We just decided to go there.”

Be inspired: Hear about new approaches, ideas and creativity in medicine by viewing this talk and others in the AMA’s Innovations in Medicine series.

Want more inspiration? Get a first-hand look at what’s driving health and medical progress today with TEDMED 2014, the annual health and medicine edition of the world-renowned TED Talks, held Sept. 10-12 simultaneously in Washington, D.C., and San Francisco.

Participate in live streaming the week of the event. Visit the TEDMED 2014 website and use invitation code “TMLicAMA14” to watch talks on demand, or view portions of the event in real-time. You also can gather a group of your colleagues and staff to view presenters of interest.

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