Resetting the Clock to 1 Year
The FHO Payment Model incentives family doctors to keep their patients healthy and require as little visits as necessary.
Thus, whenever possible, at every point of contact, your goal should be to equip the patient to be set free for a year. Certainly, they won’t always be the case, especially for complex, unstable patients. But a great deal of the time, it’s totally appropriate.
Let’s say I saw a patient on August 5th, 2022 for a Prescription renewal visit. At that visit, I opportunistically updated all of his preventative care and addressed all of the patient’s concerns. At the end of that visit, I renewed all of his medications for 1 year.
But then today on that February 17th, 2023, the patient came in for an acute concern related to knee pain. I deal with his knee concern, and then I see in my EMR that patient’s medications will be due again on July 31st:
This is a stable, competent patient. He rarely needs to come in. At today’ visit, we checked up his blood pressure the same as we do routinely at every visit. His blood pressure to target.
Well, July 31st may seem like a long time away. But, it will sneak up sooner than you expect. Instead of the patient needing to come in for another “Prescription Renewal Visit” in July, I am going to take the opportunity to “Reset the Clock to 1 Year”.
Today, I renew all his prescriptions today with another year’s worth of repeats. And I’m sure to tell the patient this so he is aware. I also remind him to get updated bloodwork for his kidney function in another couple months and equip him with a lab requisition.
I’ve just ‘reset the clock’ for this patient, starting fresh for another year.
We essentially used an acute episodic visit to renew prescriptions, thus negating the need for a prescription renewal visit this year.
And you should look to similarly reset the clock for every acute episodic visit with all your other patients.
The result is that many of those 410 patients who you thought will need extra prescription renewal visits won’t actually need to come in for those extra visits. And those extra 1.8 visits per day never actually come to fruition.
Not only that, a certain portion of your patients who are due for Prescription Renewals will decline to come in for a visit. Instead, they will pay the Uninsured Service Fee or sign up for an Annual Plan (Block Fee).