Expert Perspective

February 16, 2023

Patient Engagement is Once Again Top of Mind. What’s Different This Time?

Deb Jacobs, RN, BSN - Director of Health Services

As 2023 dawns, strategic conversations in health care are shifting away from the pandemic’s “crisis mode” to refocus on addressing long-term needs and opportunities to improve patient outcomes. Patient engagement is an area that is consistently discussed as ripe for evolution.

In an ideal world, every health care provider would be focused on patient engagement right now. The benefits of this work are clear. Engaged patients tend to have better health outcomes, are more likely to keep their chronic conditions under control, have fewer unnecessary hospital visits, and can identify serious illnesses earlier to receive treatment faster. In addition, treatment is usually more cost effective for patients who are involved in their care versus those who do not keep up with routine appointments and preventive services.

Given its importance, how can we make more meaningful progress with patient engagement?

A big reason is in the real world, providers by themselves do not have time to enrich patient connections outside of in-person visits. This leads to patients not as focused on their health as they should be. Physicians and nurses are busy to the point of burnout from handling high patient volumes and escalating acuity. Simultaneously, they are managing time-consuming administrative tasks to ensure their practices remain viable and compliant.

But what if there was a solution that could dramatically improve patient engagement without pulling physicians and nurses away from other priority tasks? Enter the idea of a designated care team. While team members may have different titles such as social workers, care coordinators or value-based care nurses, they are all trained care extenders who can connect with patients who may need extra education, coordination, and planning outside of the traditional appointment. Such patients may include those who have multiple chronic conditions, have multiple doctors or may not have seen their primary care doctor recently. Using data, a care team member can identify these and other high-risk patients to help set up appointments, answer any questions, and discuss what may be hindering a patient’s ability to access care.

How does using a designated care team differ from hiring people to make phone calls?

These care teams are uniquely qualified to engage patients because they have both the training and the time to connect with individuals and respond to the challenges they face. They often understand the clinical perspective and also have knowledge about benefits, community resources, and what a patient needs to effectively manage their health. They have the skills to look deeper and ask questions to get to the root causes of patient problems. In addition, they can facilitate connections to break down barriers. For example, a social worker can reach out to high-risk patients, identify barriers to care and connect them with community resources like meal programs, transportation services, and financial support opportunities. Using a diverse care team can help your practice improve communication with patients and remove roadblocks to care—all without adding to the workload of your current nurses and physicians who are already strapped.

The right payment model can open up more opportunities

While providers in fee-for-service arrangements can hire a care team like the ones described above, it is much easier to do this within value-based care arrangements. Capitated payment models are designed to give providers greater flexibility in how they deliver patient care. As such, these arrangements can help you bring in individuals who extend your capabilities outside of the patient appointment and provide the high-touch care and services your sickest patients need. This in turn can strengthen patient engagement efforts to ensure better health outcomes and lower costs of care.

At CareAllies, we’re committed to helping your practice make a meaningful difference in patient engagement. To learn more, go to

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