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Stepping Up Efforts for High-Risk Populations

January 2016

The value of taking a patient-centered approach to providing healthcare seems obvious. After all, the patient is the one who ultimately reaps the benefits of good health, so shouldn’t he or she also have the chance to take an active role in his treatment process, guiding his own outcomes? That’s the premise of a Patient-Centered Medical Home. Yet for healthcare organizations that provide a safety need for low-income and high risk populations, getting some of the poorest and sickest patients involved in their own care can be quite challenging.

This makes sense when you consider the fact that people and families who received public assistance may already have their own unique set of difficulties to overcome on a daily basis. Therefore, educating themselves about best medical practices, staying on top of their chronic health problems, and communicating with doctors can seem overwhelming.

For instance, consider a patient with diabetes. Part of managing his or her own care includes daily insulin checks, blood tests, medications, dietary modifications, physician visits, etc. Yet for someone living on a shoestring budget, planning ahead for meals and testing and keeping a calendar of appointments can be more than he or she is prepared to handle.

Some healthcare organizations are tackling these barriers with creative solutions and offering high-risk patients some extra help and support to make them feel less alone and less overwhelmed.

For instance, one program organizes small cooking classes for diabetes patients, to show them what types of food they should be eating and how to prepare it appropriately. The classes even include advice on how to navigate the confines of a food pantry or shelter to access the foods they need to stay healthy. A personalized “showing instead of telling” approach goes a long way toward making patients feel confident in making the commitment to try to eat better.

Other providers are using social media to stay connected with high-risk patients on a daily basis, checking in and reminding them to check their blood sugar levels and asking them to text the results back. Such small, but essential, forms of support remind safety net patients that others do care about them and their well-being.

Finally, for high-risk patients who don’t speak English, as well as those who have specific ethnic, cultural, or religious beliefs that impact their behaviors, some patient-centered providers are taking the time to understand these cultural nuances and then responding in a culturally-sensitive way. They also make a point of providing information translated into the patient’s native language.

All of these efforts surely take an extra time investment, but they also contribute to the relationship of trust between the patient and his primary care provider. In the long run, patient-centered and sensitive care can lead to better outcomes, while saving money on unnecessary treatment and helping a vulnerable population feel valued and respected.