Can value-based payments improve primary care? Ask the practitioners
Despite the overwhelming evidence of its benefits, primary care in the United States is chronically underfunded.
Decades of research have documented the benefits of robust primary care in a well-organized health care system that maximizes patient and population health, efficiency, and equity. Patients value access to and a continuous interpersonal relationship with a trusted primary care practitioner (PCP), and this relationship is associated with better outcomes for patients.
Unfortunately, the way we pay for primary care incentivizes visit volume more than quality of care, and these relationships have become increasingly challenging to secure, even among well-insured patients.
Learn what practitioners themselves have to say about challenges and solutions, in this blog by Ann O'Malley , Eugene Rich , Rumin Sarwar, and Cindy Alvarez .
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8 个月its good to read the emphasis you made on the importance of a strong patient-physician relationship. And it's clear that the current fee-for-service model is not incentivizing the quality of care we need.
Basic Health Access
8 个月So what is a primary care source anymore? Why does it take multiple times more graduates for the same result compared to the 1970s graduates Is it good to have the least experienced workforce? Since we are focused on quality improvement - we do not really know do we? What happened to a focus on most and best team members? What happened to the RN MD dyad that was a core contributed and is prevented by financial designs? NP and PA and DO expansions send out more with less experience or no experience. NP is also only 60% active and with lesser volume. NP and PA have much churn, turnover, and departure - all not the best for primary care experience with same specialty, team, practice, patients, in the same communty
Basic Health Access
8 个月So here are your primary care stars - decimated by design, and requiring so many graduates of any source or all sources, that primary care cannot be moved to sufficient - especially in 2621 counties with les than 20% of primary care spending and a most complex 40% of mouths to feed
Basic Health Access
8 个月The collapse of IM and NP primary care. IM by losses and NP by expansions that result in increases in numbers but lower and lower proportions in primary care. only 15% active and in primary care will do that since NP remains about 60% active (likely less) and 25% primary care in relicensure studies (likely of those active) in OR and WA
Basic Health Access
8 个月So we are moving from the most experienced primary care workforce to the least experienced as shaped by massive expansions of NP and PA and losses of experienced MD DO NP and PA by design By 2010 all were equal at 50,000 apiece but obviously IM in a major way is still falling with some declines in FM with PD steady (less incentive to do fellowships) and with NP and PA picking up the slots that others left to the limit of what 250 billion minus costs of delivery will allow - which is less and less