Brittany Watson, MD, MPH

2022-2023

Associate Medical Director; North Carolina Medicaid; Assistant Professor, Atrium Wake Forest Baptist Department of Family Medicine

Brittany Watson, MD was most recently a family physician at Affinity Health Center, a FQHC in Rock Hill, SC. Dr. Watson has demonstrated interest and investment in public service; she is passionate about diversifying the medical workforce, and access to affordable healthcare and basic health education. She received the Society of Teachers of Family Medicine 2019 Resident Teacher Award, given to a graduating resident in recognition of demonstrated interest, ability and commitment to family medicine education. She was appointed as American Academy of Family Physicians Leading Physician Well-being Scholar in 2021. Dr. Watson received her medical degree from the Medical University of South Carolina in 2016.

Advancing Person-centered Care Planning for People Living with Multiple Chronic Conditions to Improve Outcomes

Background: People living with multiple chronic conditions (MCCs) comprise 27% of the United States population.2 The prevalence will increase as healthcare continues to innovate and life expectancy rises. MCCs disproportionately impact Black and low-income individuals.3 Moreover, MCCs affect patients and their loved ones. The burden is felt across the healthcare system and beyond. With MCCs accounting for 71% of health care spending, and health care’s increasing impact on the gross domestic product (18.3%), society has a vested interest in improving the care of those living with MCCs.4 Person-centered care planning has an important role in advancing the care of individuals with and at risk for MCCs. The conversation surrounding care planning is not new, yet there is little reporting of best practices and models. Most implementation strategies are completed in silos and are not published.

The purpose of this project is to understand the current landscape of person-centered care planning. The goal is to centralize information to analyze for best practices that will improve outcomes for people living with MCCs. The United States Agency for Healthcare Research and Quality (AHRQ) released a request for information (RFI) in September 2022 in order to gather national feedback.

Objectives:

  1. To understand the current state of comprehensive, longitudinal, person-centered care planning for people at risk for or living with MCC across care settings.1
  2. Understand existing models of person-centered care planning, their current scale, barriers, and facilitators to implementation.1
  3. Highlight innovative models of care, approaches, promising strategies, and solutions for clinicians and practices to routinely engage in comprehensive, longitudinal, person-centered care planning to improve the care of people at risk for or living with MCC.1

Methods:

  1. AHRQ published a RFI for public comment.
  2. Performed a literature review to understand the current academic landscape of care planning, and to identify recommended best practices.
  3. Conducted a qualitative analysis of the request for information responses.
  4. Plan to release results to inform policy and practice.

Results: AHRQ’s RFI was highly successful and received fifty-nine responses. Respondents represented diverse perspectives. Patients, payers, health systems, care givers, community organizations, professional organizations, advocacy organizations, providers, researchers, educators, and more responded. Preliminary analysis shows seventeen categories, seventy subthemes, and forty-three examples/models. The highest frequency themes related to barriers, payment, and placing patients at the center of their care with providers, caregivers, and communities surrounding.

Next Steps:

  1. Refine themes.
  2. Distribute findings to government agencies
  3. Report findings to the Office of the Assistant Secretary for Health (OASH)’s Initiative to Strengthen Primary Health Care.
  4. Convey findings to the public in the form of a white paper or publication.
  5. Analyze the examples/models for common elements to inform best practice standards.

Preceptor: Arlene Bierman, MD, MS Director, Center for Evidence and Practice Improvement at Agency for Healthcare Research and Quality

Citations:

  1. Request for Information on Person-Centered Care Planning for Multiple Chronic Conditions (MCC). Federal Register. Published September 16, 2022. Accessed March 20, 2023. https://www.federalregister.gov/documents/2022/09/16/2022-20027/request-...
  2. Boersma P. Prevalence of Multiple Chronic Conditions Among US Adults, 2018. Prev Chronic Dis. 2020;17. doi:10.5888/pcd17.200130
  3. Caraballo C, Herrin J, Mahajan S, et al. Temporal Trends in Racial and Ethnic Disparities in Multimorbidity Prevalence in the United States, 1999-2018. Am J Med. 2022;135(9):1083-1092.e14. doi:10.1016/j.amjmed.2022.04.010
  4. Martin AB, Hartman M, Benson J, Catlin A, The National Health Expenditure Accounts Team. National Health Care Spending In 2021: Decline In Federal Spending Outweighs Greater Use Of Health Care: Study examines national health care expenditures in 2021. Health Aff (Millwood). 2023;42(1):6-17. doi:10.1377/hlthaff.2022.01397