Think about your favorite brands, whether it’s a product, service, or professional consultant. Now consider why you feel loyal to that particular offering: Is it always sold at the right price? Is it a status symbol? Or does the brand always deliver a consistent level of satisfaction?
Your answer may be “all of the above.”
A QualityPath Referral
Now consider your personal physician. It’s likely this individual is one of your favorite “brands,” someone you may have trusted over the years and perhaps used as a resource for referrals when you needed more care.
So when you require high-stakes surgery – knee replacement, total hip replacement or heart bypass surgery, for example why would you opt for a surgeon in the QualityPath program and disregard the referral from your physician?
The answer is simple: Your employer has made a commitment to providing you and your family members with information and support that will lead to better decision-making about where to have high-stakes surgeries.
An Investment in Your Health
QualityPath is an investment that your employer’s leadership is making in your health. This investment is based on your organization’s membership in The Alliance, a cooperative of employers and insurance trusts that self-fund their health benefits.
Like so many corporate leaders nationwide, your employer has learned that workers appreciate guidance about quality care for high-stakes surgeries. Over the years, employers have learned that
people are frustrated about the lack of information to guide them in making the right choice.
Employers participate in QualityPath because they know steering employees and family members to doctors and hospitals that meet national quality measures helps lead to better outcomes. They
reinforce this guidance with health benefits that cover 100 percent of medical procedure costs, including pre-surgery consultations, the procedure itself, and post-surgical care and rehabilitation
(special provisions apply if you have a health savings account or HSA).
Think of QualityPath as a special perk – one that is in your own best interest for attaining a better surgical outcome, avoiding unnecessary tests, reducing out-of-pocket costs and lowering personal stress levels.
Dealing with a ‘Sticky Situation’
But all this great advice doesn’t change the fact that you are still in a “sticky” situation with your own doctor, who may try to pressure you into seeing the surgeon that he or she recommends. Don’t be surprised, in fact, if your doctor discourages you from using the QualityPath surgeon or hospital. In this situation, remember that your loyalty to the “physician brand” only goes so far – this is your decision and it impacts your health and your budget.
The key is to be prepared to address this situation with information and facts.
Four Steps to Prepare for the Conversation
These four steps can help you prepare for the conversation.
- Read all you can about QualityPath and understand the significant opportunities for better health outcomes.
You’ll learn that QualityPath introduces a new approach to care. For example, you’ll get a 90-day warranty on QualityPath procedures as protection if you need additional care due to preventable problems. The more you know about QualityPath and its approach for creating a decision-making process based on patients’ needs and values, the better equipped you will be to explain your position to your doctor.
- Place you on the record as a QualityPath participant so that you qualify for bundled prices, warranties, lower out-of-pocket costs and other advantages.
- Offer assistance to transition medical records and care to QualityPath providers. While you are entitled to these records under HIPAA federal government policies, this help eliminates one more issue for you to address with your personal doctor.
- Make sure hospitals and doctors recognize your participation in QualityPath.
- Remain in touch to answer questions and streamline the process.
- Speak to your physician one-on-one about your decision to access care from a QualityPath surgeon. Be specific. Bring along information about QualityPath. You can get this information online, from your employer or from the patient experience manager.You might want to include information about the QualityPath doctor and hospital that you selected. It could help your personal physician better understand why these individuals and institutions are part of the QualityPath initiative.You might also want to tell your doctor that you are looking forward to the patient experience manager’s personal assistance.
- Consider putting your thoughts in writing – a personal note to your physician might be appropriate and will help to make the discussion easier for both you and your doctor. For example, you might say:
A Better Experience Awaits
Whew! Now that you’ve successfully tackled this awkward task, a better patient experience awaits. QualityPath is likely to become your favorite medical “brand.”
Carabello serves as a member of the advisory board of the International Medical Tourism Association and is the publisher/managing editor of Medical Travel Today for the medical tourism industry as well as Your Medical Travel for consumers. She holds a bachelor’s degree from the Newhouse School of Communications at Syracuse University.
Latest posts by Laura Carabello
- Who do you trust for a medical referral? - February 17, 2015