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How a new model of care improves outcomes while lowering costs

Originally published in The Tennessean, March 2021 

Recently, I heard a story about a young woman in her 20s that stuck with me.

She was experiencing chest pains and had visited an emergency department. The symptoms continued and she visited a Sanitas Medical Center in Murfreesboro and spoke with a nurse practitioner on staff. This nurse practitioner listened to her story and took the usual clinical steps, but told her, “I’m concerned there’s more going on here. I think you need a chest CT.”

The nurse practitioner’s expertise and genuine concern stuck with her, and she trusted him. So she followed his recommendations and obtained a CT of the chest.

That CT revealed she had a pneumomediastinum, where oxygen is leaking outside the lung and into the surrounding membrane. This condition can be catastrophic. And it likely would not have been discovered had that Sanitas nurse practitioner not made that connection with that patient and stressed the need for additional care from the health care team.

As regional medical director for Sanitas, I share this story to illustrate two points: one, building trust with patients — and getting the right care in the right place thanks to that trust — makes a huge difference. And two, patients accessing quality care on their schedules can be a real challenge. “When my doctor’s office is closed, where can I go?” “Did I get the right service?” “What’s this going to cost?” We all ask these questions.

The shared goal between Sanitas and our partners at BlueCross BlueShield of Tennessee is to address both of these points and improve health outcomes for Tennesseans. We do so by providing convenient, cost-effective care that follows best-practice standards. 

Sanitas began opening centers in middle and west Tennessee in late 2020, expanding access to primary care and providing preventive care, urgent care, and chronic disease management. Sanitas only sees BlueCross members, ensuring they receive highly coordinated care. This includes assistance with referrals to in-network specialists and maximized coverage benefits consistently tied to their primary care physician. 

We’ve opened six centers thus far, offering same-day appointments, extended hours and enhanced digital tools that make connecting with care teams and medical center staff and sharing health care data easier.

This new model of care appealed to me — as a native Memphian and retired OB/GYN who was part of a multispecialty group, I’ve long been passionate about both the practicing and business sides of medicine. Joining Sanitas last year presented an opportunity to keep people well, keep them out of the hospital and emergency department when not necessary, help them stay on their medications, and help them manage pre-existing conditions, resulting in lower health care costs.

It’s not a matter of bringing large numbers of people into these centers; it’s about building relationships and seeing proper care through for those who come in.

That means staying engaged with patients after they’ve visited a Sanitas clinic. Telemedicine in particular is evolving as an effective approach for follow-up visits and patient education, particularly for behavioral health. Not every patient needs to fight traffic for 30 minutes. If we can do something that’s convenient and accessible, and get the same excellent care and the same good results, this is a game changer. Our general rule is that telemedicine will accentuate the personal relationship. It won’t be the relationship.

As that young patient’s story demonstrates, creating a support system for this type of value-based care takes patience, perseverance, and a belief that what you’re doing is going to make a difference. We know that if you provide access and an environment where volume is not the driving force, then you have a better patient and provider experience.

About Keith Williams, M.D., Regional Medical Director, Sanitas Medical Centers

A photo of the authorKeith Williams, M.D. is regional medical director for Sanitas Medical Centers. He is responsible for clinical strategy for the primary and urgent care centers serving BlueCross BlueShield of Tennessee members.

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