The Impact Of Personalized Preventative Care On Health Care Quality, Utilization, and Expenditures

The personalized medicine approach utilizes the primary care physician to provide individualized treatment focused on preventative care, wellness management, and strong provider and patient coordination. This study compared healthcare service utilization and cost outcomes of propensity matched personalized medicine members versus nonmembers. Personalized medicine members received the personalized medicine approach at an average monthly rate of $150. Tracking for care and its effects was done over the durations of one, two, and three years. It was found that the total cost was higher on average for members, especially in year one, the average cost for healthcare service utilization (including membership costs) was essentially the same for both members and nonmembers at year three. The large discrepancy in year one was attributed to increased prescription use for better chronic condition management. 

The study found healthcare utilization was reduced overall for members compared to nonmembers. A metric I found very interesting was the discrepancy of the percentage of individuals that had any ER or urgent care facility usage. For example, at year three, 14.6% of personalized medicine members utilized the ER and 4.5% utilized urgent care facilities. Compare this to an ER utilization rate of 17.3% and an urgent care utilization rate of 10.1% for nonmembers. The data seems to point at the powerful effect of preventative care in reducing extra healthcare service utilization, possibly hinting at an effect of better health outcomes. I believe this is important, as we should be proactively looking to solve the root cause of the problem instead of reactively trying to address it when it occurs. 

The underlying premise of the model is that the focus on prevention and wellness and the additional time, attention, and access to physicians (ie, higher quality of care delivery) will lead to better health status, lower emergency room (ER) visits and hospital utilization, and ultimately lower health care expenditures. 

Utilizing technology to provide physicians and patients a holistic view of their long-term health could lead to better and more personalized care, resulting in healthier individuals and less healthcare service utilization. 

Extending the time of wellness visit lengths to 60–90 minutes removes one of the major barriers cited by physicians as hampering their ability to counsel on lifestyle modification. 

Telemedicine could be helpful in providing patients and physicians more time for counseling

Spending more time with patients and physician counseling on behaviors have been associated with higher trust among patients.³⁹ In turn, trust in one's physician has been linked to improvements in many factors, including patient-physician communications, satisfaction with health care, compliance with medical protocols, and continuity of care. 

How do we build more trust between patient and provider?

Managing lifestyle health risks remains especially important to patients in midlife and as they age to delay the onset of disease and disability and to facilitate the management of existing chronic conditions. 

Health tracking and behavior modification could be very useful here 

Medical services utilization patterns indicated a significantly reduced use of the ER in years 2 and 3 and urgent care facilities in all 3 years. This is consistent with greater access to the patient's PCP, thus reducing the need to seek care in outside facilities. 

With emergency care being a service that was difficult to access from the people I surveyed, any way to reduce utilization could be a helpful solution

Reference

Musich, S., Wang, S., Hawkins, K., & Klemes, A. (2016, December 1). The impact of personalized preventive care on health care quality, utilization, and expenditures. Population health management. https://pmc.ncbi.nlm.nih.gov/articles/PMC5296930/

No generative AI was used in the writing of this post