Results Indicate a Need for Improved Communication
The Northeast Care Management Center’s review of provider records reveals that improvement in communication with the member’s primary care physician (PCP) is needed.
- Only 52.2 percent of records contained evidence that the provider requested member authorization for communication with the PCP.
- Documentation showing that communication with the PCP occurred after initial evaluation appeared in only 48.7 percent of records, which dropped from 61.3 percent the year prior.
- Evidence of at least one communication with the PCP at other significant points in treatment dropped from 70.3 percent to 28.6 percent.
On a positive note, providers are doing better in documenting when a member has refused the communication. This score jumped from 74.5 percent to 90 percent.
For further information on the importance of care coordination with PCPs and recommendations to help you address this most critical element of patient care, see our feature article published in the Summer 2009 Provider Focus.