Provider burnout isn’t new. It existed long before COVID and was exacerbated by the pandemic. But it’s rising to new levels. For example, recent labor issues at Kaiser—resulting in the biggest healthcare strike in US history—were caused in part by acute staffing shortages that drive provider burnout.
To combat burnout, healthcare organizations are raising wages. Most are strengthening hiring and retention efforts, along with a variety of other tactics. Some states are pursuing safe staffing legislation. The situation is dire and creating an impediment to achieving the CMS Triple Aim: improving patient care, reducing healthcare costs and improving population health. More recently, recognizing the importance of provider engagement and wellness, healthcare leaders have considered expanding to a Quadruple Aim to include the clinician experience.
Ramifications of burnout
- Providers at all levels are exiting the field.
- Private practice consolidation: Share of physicians working in private practice continues to dip | Healthcare Dive.
- Decreased earnings.
- Increased potential for medical errors, including providers less likely to identify and address all of a patient’s chronic conditions.
- Increase in cost of care.
- Admin tasks for physicians up 15%.
- The effects are particularly evident in the primary care field and move us farther away from achieving the Quadruple Aim.
Less common solutions to a common problem
Aside from obvious solutions—staff recruitment and wage increases—what else can be done?
One area of focus should be administrative burden, with physicians spending nearly 2 hours a day on EMR tasks outside work. While EMRs bring needed automation and better data, they’ve become more complex, driven by increasingly detailed and nuanced data requirements that create stress and distract from patient care. Alert fatigue is one result of this stress and distraction, which is exacerbated by vendors that send unvalidated conditions and codes directly into the EMR and physician workflow.
Additionally, healthcare policymakers and regulators continue to mandate more documentation to demonstrate compliance with laws and standards, resulting in lengthier documentation. Value-based care (VBC) payment models, which are becoming more common, require even more clinical support, coding and documentation to achieve performance goals.
At Vatica Health, clients appreciate our unique model of supporting providers with clinical and admin resources. We’ve found these strategies reduce the admin burden for our provider clients and support their transition to VBC payment models as well:
- Offer physician training on standard coding and documentation practices: get all providers on the same page in terms of process and workflows.
- Align physician compensation with VBC initiatives: ensuring that physicians are compensated and incentivized is paramount to obtaining physician buy-in and ongoing participation. By thoughtfully designing compensation programs for both clinical and support staff, provider groups can counter the problems of physician burnout, declining retention and shortage of physicians.
- Optimize the EMR and pre-encounter prep to drive efficiency and comprehensive visits: EMRs on their own do not sufficiently support coding and documentation to optimize VBC performance. Solutions are available that optimize EMR performance to help identify care gaps and facilitate accurate coding.
- Create better alignment with payers and advocate for programs that remove operational burden associated with risk adjustment and quality initiatives: these programs can help provider groups realize incremental revenue, improved outcomes, increased numbers of preventive health encounters and improved performance in VBC arrangements.
- Provide support to help physicians capture and address SDOH: successful programs include training clinical staff, providing access to local resources, developing workflows and promoting standard practices that help simplify the risk-adjustment process, including allocating time during patient encounters for these critical conversations.
- Be transparent about the financial impact of physician performance in VBC: executive leaders should share financial performance data with physicians and potentially other staff as well. Incremental revenue earned through participation in such programs can support a financially positive outcome for the group.
A select few health plan-sponsored solutions relieve administrative burden and help improve clinical and financial performance. One example is Vatica Health, where licensed clinical nurses are assigned to each contracted practice. The nurses create a comprehensive, curated Vatica medical record for each patient encounter, presenting only conditions that are fully supported by clinical documentation. PCPs receive a streamlined, prioritized list of conditions that they can review at their convenience.
Provider group leadership should consider all viable options to address provider burnout – especially as VBC transformation creates more demands. Recruiting additional providers gets tougher as competition for fewer physicians, mid-level practitioners and nurses escalates. Finite financial resources limit never-ending wage increases. Leaders should consider out-of-the box solutions, such as payer-sponsored programs that include additional clinical and administrative resources to support providers.
Vatica’s clinical and admin resources can reduce PCPs’ burden from coding and documentation. That not only improves provider experience but keeps the PCP central to patient care, supporting the patient experience as well. Vatica helps PCPs address chronic conditions, identify care gaps to more easily resolve them and present the most accurate picture of the patient’s condition. An accurate picture results in appropriate reimbursement, avoiding over- and under-coding that impacts overall healthcare costs. This moves us in the right direction to achieve the Quadruple Aim and gives provider group leaders concrete resources to address physician burnout.