Dr. Kevin Theodorou is a primary care doctor at Internal Medicine of the Valley. He opened the practice in 2002 and joined ACN shortly after it launched. He currently serves on the Next Generation ACO Board of Managers and previously served on the Quality & Performance Management Committee. Earlier this spring, Dr. Theodorou was kind enough to share a little bit about his path to success.
Your practice scored over 90% in patient experience (Net Promoter Score). What are some ways that you ensure a positive experience for your patients?
I just be myself. I want my patients to know that I’m a person, not just their doctor, and I’m listening. I never want someone to leave the office feeling like they were rushed out the door. I would much rather take the time to address their concerns and fall a little bit behind in seeing my patients than have them feel like their voice wasn’t heard.
My interactions with that patient are part of it, but the other important part is how my staff interacts with the patient. I’ve been blessed with low turnover. My receptionist had been with me for over 10 years. Unfortunately, she recently left, but I want to hire staff members who treat patients like a customer – the patient is always right.
It’s easier said than done. I recognize the benefit of being a sole practitioner. My patients like that. They get a level of personalization that they might not get in a bigger practice. They feel like their voice is heard.
How do you maintain such a high clinical quality score?
The score is broken down into a few key areas – blood pressure, diabetes, depression and statin therapy. I’ve built a process around managing those.
For example, if a patient comes in and their blood pressure is high, I’ll ask them to come in for another visit in two to four weeks to stay on top of it. If their A1C is high, I try to get them back in four weeks. I’ve found that frequency of visits for blood pressure and diabetes helps me get the patient to where they should be. I’ve also told my staff that every patient gets a depression questionnaire.
I keep the same process for all my patients. I just go down the list. Have they completed the depression questionnaire? Is their blood pressure under control? Are they diabetic? Have they had all the necessary screenings – colonoscopy, mammogram, etc.? I built that process to ensure that I check all the necessary quality measures and I have a process for getting the CPT II codes inputted quickly.
Another important element to value-based care is in-network utilization. How do you ensure your patients get their care within ACN?
It’s simple, really. I tell my staff to use par8o. If the provider is not in par8o, I won’t refer to them. Within the system, I can find specialists in a certain geographic location and initiate the referral. Again, it’s just part of the process. Once my office staff figured out a workflow for par8o, it became habit for all ACN patients.
What advice would you give to a provider who’s new to an ACO?
Embrace it. The fact that you’re essentially being graded for your care can be a great motivator. The data lets you know exactly how your patients are doing and if you need to make an adjustment. I believe there’s always room for improvement, but it’s not easy to get better on your own without someone pushing you a bit.
I’ve seen the overall quality of my care improve and I’ve been compensated for that through the Provider Rewards Program and gain share. It’s a win-win.
If someone felt like they were struggling with ACN, what advice would you give them?
Invest time upfront to develop the process. Once you develop a process, apply it to every patient and you’ll find that it becomes habit. And once you’re in the habit of checking the right boxes, your performance will likely improve. It requires some coordination with your front office staff and you need to figure out workflow, but I found that once I did that, it’s not so overwhelming. In fact, it’s quite rewarding.
