By Matt Kuhrt
There may not be a silver bullet to solve the issues in the U.S. healthcare system, but among the current crop of initiatives to improve cost and quality of care, efforts to buttress primary care provision via the creation of patient-centered medical homes (PCMH) are showing promise, according to a report from the Patient-Centered Primary Care Collaborative.
The tectonic shifts in the healthcare industry have led to a scramble among patients, doctors, administrative entities, insurance companies and the federal government in search of a way to balance political, social and economic pressures and settle on an effective, cost-efficient overhaul of healthcare provision.
That has put the spotlight on primary care, an area where the United States has spent a fraction of its healthcare expenditures, even while primary care offices see 55 percent of all visits to medical offices per year, according to the report.
In a PCMH, comprehensive, coordinated primary care is delivered by a network of clinicians and staff in order to improve patient access to care. That means changes for all stakeholders involved, starting with patients, who have embraced the idea of visiting practices for care rather than individual physicians.
The transition is more difficult for doctors. While FiercePracticeManagement has reported an increased number of physicians turning to additional staff members to improve care access and mitigate burnout, the financial burden involved with getting a PCMH off the ground continues to be a hurdle, in addition to the continuing need for state government support.
Enter the payers. Multi-state studies, including programs from Anthem Enhanced Personal Health Care, as well as collaborative efforts from the Comprehensive Primary Care Initiative and the Multi-payer Advanced Primary Care Practice Demonstration, demonstrated substantial cost savings across their footprints. Added to state-focused efforts, 21 of 23 studies reported reductions in one or more cost measures and 23 of 25 found reductions in one or more utilization measures, per the report.
What's more, the longer these initiatives have been around, the more their cost and utilization metrics improved. Payer participation could signal a further increase in motivation and resources necessary to move more doctors to PCMHs, since "alignment of both payment and performance measurement across public and private payers is key to garnering support from primary care practices transitioning to these value-based payment models," write the report's authors.
To learn more:
- read the report