WASHINGTON – Interest is growing in a new concept of providing care that puts an emphasis on primary care and changes the dynamics for how care is financed.
The Patient-Centered Primary Care Collaborative held one of its quarterly meetings in Washington last month, attracting interest from large employers, Congressional staffers and state Medicaid directors.
The organization, which represents a coalition of employers, physician groups and consumers, is advancing the concept of the patient-centered medical home, which would provide physicians with additional compensation for helping patients stay healthy.
The approach came out of discussions between large employers, which were seeking better value for their healthcare spending, and physician organizations, which seek to have doctors play more of a role in coordinating care.
“We hope to see a change in the system of care in the U.S. that promotes the principles of the patient-centered medical home,” said Rick Kellerman, MD, president of the American Academy of Family Physicians, one of four professional organizations representing a total of 330,000 physicians.
In the patient-centered medical home approach, every patient has a personal physician who provides first-contact access to the system, provides most care, ensures continuity of care and has enough information to fully understand how to treat a patient.
The collaborative can point to a small-scale version of the approach, now in use in North Carolina’s Medicaid population. There, additional expenditures of less than $10 million produced savings of more than $240 million since its inception, said Edwina Rogers, vice president for health policy at the ERISA Industry Committee, a Washington-based sponsoring organization.
Three other states are considering versions of the North Carolina approach, Rogers said. And the quarterly meeting in Washington included a presentation before state Medicaid directors, said Paul Grundy, MD, director of healthcare technology and strategic initiatives for the IBM Corp.
The organizations claim support from companies employing some 50 million Americans. Last month, the collaborative gained support from AARP, which has 35 million members over the age of 50.
The collaborative is working on a tiered payment system for physicians, who would be compensated at different levels depending on their commitment to oversee patients’ care.
An agreed-upon payment model then can be offered by payers, at the behest of large employers that will ask for the health benefit to be made available to their employees, Rogers said.
The collaborative is looking for other opportunties to pilot the concept, Grundy said.
“We are very early on,” he said. “We are looking at one of the areas of the country where we have a large core of employees, working with that community where we can really change what we’re buying and allowing physicians to have the tools to deliver connected primary care.”
The initiative is also looking at ways to equip physicians with essential information technology without requiring them to make the entire investment up front, Grundy said. “It’s not fair to ask the providers who get only 10 percent to 20 percent of the benefit to foot the whole bill,” he added.
The recent presentations included discussions with Congressional staffers and others who are intrigued by the movement.
“What was accomplished was a continuation of coalition building and really getting some legs, both in corporate America and in Washington,” Grundy said.