“image Intensive outpatient care for complex high-needs patients - FBMC Benefits Management, Inc.
Intensive outpatient care for complex high-needs patients

March 12, 2020

We here at FBMC believe education is the key to affecting positive change in the healthcare system. This leads me to March topic: Intensive Outpatient Care for Complex High-Needs Patients. All of those words together sound quite intimidating, but we’re here to take some of the confusion out of navigating the healthcare system.

A complex high-needs patient is someone with compounding medical, social, and behavioral challenges that prevent a person from maintaining his or her health. For example, let’s say John mismanages his diabetes which leads to heart disease and near blindness. Not only does John suffer from these medical conditions, but he also has expensive insurance coverage and unhealthy habits. Over time, his medical conditions worsen, and he needs care NOW. So, he goes to the emergency room to then spend months in the hospital recovering until he is stable enough to leave. What happens next is a vicious cycle of John not getting care that addresses his life challenges, but only treats the physical symptoms that present themselves when his situation is critical.

Now, let’s get to the uplifting solution of Intensive Outpatient Care. A set of doctors, nurses, and social workers work together to address a patient’s needs without resorting to extended hospitalizations. The goal is to help the patient in his or her everyday life attain access to care and build healthier habits. This happens by first addressing the patient’s ability to get access to consistent care. Second is building trust between the patient and his or her care team so they can work together to solve problems. Last is having the patient start to manage their care or at least certain aspects of their care by themselves. This system disrupts the patient’s habits of mismanagement, creates a clearer, consistent health plan, and offers the patient a chance to be informed and own his or her healthcare.

As his employer, how can we also help people like John? It starts with understanding his needs just like the Intensive Outpatient Care. Will the current benefits package offer the kind of help he needs? How can we help him practice healthier habits to support management of his diabetes? As an employer, you can create a culture of physical and mental well-being that encourages making the right health choices. This includes programs that reward employees for reaching or maintaining health goals. Even offering free water and exercise competitions can encourage employees to partake in a healthier lifestyle.

When considering insurance coverage, the key is to keep insurance flexible, allow ease of access, and keep costs as low as possible. This includes negotiating for better rates, offering supplemental insurance, or seeking out government assistance resources that may help your employees. For ease of access, programs like telehealth allow people to contact a doctor for minor problems before they get worse; thereby, easing the number of patients visiting healthcare facilities. With good insurance benefits and a quality care team, John can find a way to stay healthy and meaningfully contribute to your company.