The Importance of Healthcare System Collaboration: Helping Members Stay Connected to Their PCPs for Better Health

By Ryan Heyborne, MD, MBA, FACEP, Matrix Chief Medical Officer

During our Comprehensive Health Assessment (CHA), we review members’ health and safety and help identify and close care gaps to ensure they continue to get the best care possible based on their needs.

However, another important goal of the CHA is to empower members to proactively manage their own health, and in doing so, maintain a consistent relationship with a primary care provider (PCP).

What we tell the members we serve is that our CHA does not replace the relationships they have with the trusted medical professionals in their life. It augments them by providing access to an extra health check in – in the comfort of their home.

 

Ensuring continuum of care through collaboration

The CHA is an annual in-depth, in-home visit made available to members by their health plans. It serves as a conduit between PCP appointments to help ensure members are maintaining their best health and any ongoing support they need is being addressed. For our clinicians, this can range from identifying a serious health condition that needs immediate attention to simply offering recommendations to community resources.

For many urgent unmet needs or elevated test results, we call the PCP, so they have the information to follow-up with the member accordingly. When the CHA visit is complete, we send a health status report to both the health plan provider and PCP. And, for members that don’t have a PCP, we make a care management referral and collaborate with their insurance provider to ensure one is established in their area.

 

Educating members on the value of health maintenance

Offering a more personal in-home health visit is another opportunity to educate members on the importance of taking care of their health and reminds and motivates them to stay connected with their PCPs. And we are seeing they do.

Based on a recent evaluation Matrix conducted, after receiving a CHA, 48 percent of members followed up with a PCP visit within 30 days, 68 percent within 60 days, 78 percent within 90 days, and 84 percent within 120 days. And, of the members who responded to our customer satisfaction survey to date, 96 percent replied “yes” when asked: “Was the visit of overall benefit to you?”.

 

Providing in-home health points members back to their PCPs

Members often say to us: I have great care, but I really appreciate your second set of eyes.

On behalf of the PCPs responsible for ensuring members stay in their best health and have access to the right care, our clinicians visit members in their homes, sit in their living rooms, and not only evaluate their health and safety but reinforce how much it matters.

It’s a collaborative relationship critical to every member’s health journey.

Learn more about Matrix’s Comprehensive Health Assessments.