The next stop on the journey to value-based care is tight integration between PCPs and specialists. Achieving the right balance between the two requires finding the equilibrium point between not enough primary care and too much specialty care. You can ask PCPs to do more specialty care, or you can ask specialists to do more primary care. Neither situation is ideal for patients. A better solution is to develop seamless, "automatic" coordination in the gap between the two that does what's best for patients, shares risks/rewards, and fosters collaboration. Full self-driving healthcare (FSD-HC) is achievable. #medicine #healthcare #health #healthcareinnovation #valuebasedcare
Sandra Raup
7 个月
How will adequate and timely communication be accomplished? I personally like #RubiconMD but have not heard much from them lately. Are they part of the mix?
Respectfully disagree. The next stop on that journey is eliminating fee for service care. Everything else will follow.
Chad Piatek
7 个月
Direct pay solves alot of this, when you need to build "value" of your offering directly towards the patients, these networks and systems would naturally be created to provide broadened treatments and streamlined offerings.
Ozzie E Paez
7 个月
Reform cannot conflict with providers’ business models because, like it or not, financial considerations will ultimately prevail. Ask yourself whether specialist services are more profitable-they often are. If so, then the financial incentives will disproportionately favor them. Technological innovations often benefit generalists by simplifying complex services and procedures. They can also make possible new standards of care and procedures ideal for specialists. These forces can be magnified and diminished internally by businesses models and externally by market structures and competition. These are the forces that will ultimately drive what and how value based and other care delivery models will work. What about patient interests and wants? I dare you to find programs based on what patients’ want. It’s always third parties who claim to know and speak for patients, I.e., CMS and other insurers, politicians, providers, and often conflicting clinician groups. Healthcare is the only industry I know in which customers (patients) have little to say about what they want and prefer. It is this industry characteristic that AI and other emerging technological innovations are threatening. We’ll know the results soon enough!
Corey Amann, MD, MBA
7 个月
AI can definitely help PCP's do more specialty care like they used to 40 years ago they have pushed so much away because of time constraints of having to see more patients faster
Brian de Francesca
7 个月
As PCPs become supported and augmented by AI - running on cloud based quantum computers - that has continual access to all medical knowledge and information - they may start to resemble multi-specialists. Or not. We shall see.
Robert Bowman
7 个月
Direct primary care and concierge care are too few - but are required due to the financial design for primary care. Capitated primary care is required, but payers are also unwilling to pay to cover the increased costs of delivery. This leaves CHCs which are integrated by design, but face grossly underfunded finances with 50% Medicaid and Congress holding them hostage for pennies of increases. CMS votes 1.4 trillion dollars a year against what CHCs and basic health access are all about. CMS shapes 1. insufficient services and workforce and access for half of the nation, especially the 40% in 2621 counties lowest in health care workforce paid 15 - 30% less by CMS and made worse by narrow networks, delays, denials, and big on small abuses - a unique and deadly characteristic of US health care design. 2. Fewer and lesser delivery team members. This is directly shaped by insufficient finances, made worse by forced higher costs of delivery, made worse by meaningless burdensome micromanagement duties, and made much worse because being a team member in the RBRVS and most lines of revenue favored specialties can usually result in most and best team members to share the complexity You cannot fault job changes based on better futures
Delanie H.
7 个月
Option 3 - Functional Medicine serving as the intermediary between primary and specialty care, catering to individual patient needs. To attain equilibrium in healthcare, we must adopt a systems biology approach, focusing on addressing root causes. Patient-centered care requires personalized multimodal treatments over the narrow focus of one-disease/one-target/one-molecule philosophy prevalent in primary and specialty care. Food for thought ????
Edward B. Krumpotich
7 个月
These conversations are not binary and collaboration is spot on. As a patient, I celebrate the communication between providers. From my perspective, including me and patients in these converstions may help to shed Light into the trust and path. Could it be that orthopedic is a better PCP from my perspective. I myself used PCP’s for infectious disease care for years and the positive outcome was in part due to a valuation of bedside manner, expertise and willingness to collaborate with me. The line ebbed and flowed and some of the best care I experienced was when providers found time to journey outside of their comfort zone and I said yes.
Network Chief of Orthopaedics, Rheumatology, Physiatry and Rehab
7 个月Thanks for sharing Benjamin Schwartz, MD, MBA! You've always got an incredibly thoughtful perspective that gets me thinking too. We have been working on another way to restructure healthcare delivery that has a lot of similarities to what you're thinking with regard to VBC and how primary and specialty care work together. We believe the two should actually have completely different and separate billing and implementation structures. Ideally, primary care should be the ongoing maintenance of health for the whole person and specialty care should be in the context of a specific diagnosis in a specific timeframe. It has never made much sense to me that they are implemented and paid for in nearly the same way. Let's find a time to talk more soon!