As the healthcare industry continues to change and consolidate, it’s increasingly important for family physicians to embrace high-value, patient-centered care, coordinating among providers through technology and data exchange. Through cooperation and community involvement, physicians can find new and effective solutions for the many challenges ahead.
For family medicine to begin the transformation process, the patient-centered medical home model (PCMH) must be implemented. Through this model, family physicians provide coordinated care for their patients in a multidisciplinary healthcare system, the end goal being to improve patient outcomes and reduce costs. As there’s a shortage of family physicians and financial incentives haven’t yet aligned, reaching this goal may prove to be a great challenge.
Some payers have established bonus payments for PCMH participants. However, family physicians often go without compensation for the time spent developing and coordinating care. The Agency for Healthcare Research and Quality stated in a recent report that the current fee-for-service payments are not enough to pay for the additional resources needed for care coordination.
It also remains uncertain if the PCMH model will lead to the promised healthcare costs reductions. Established medical homes across the country have been successful but other research has called these savings into question. However, regardless of what model is used, the healthcare industry’s success depends largely upon provider collaboration.
While the PCMH model provides care coordination within a defined practice setting, EHR interoperability remains a roadblock for collaborative care on a larger scale. In June, the Office of the National Coordinator for Health Information Technology (ONC) announced its plan to achieve interoperability nationwide by 2024.
Many family physicians are also looking for practice models that can relieve some of the administrative burdens tied to fee-for-service payments. The direct-pay model may be an alternative for them to consider. In this model, a practice provides same-day visits, testing, house calls, video consultations and other primary care services for a membership fee. With direct pay, physicians see less patients per day but for longer periods of time, focusing on providing quality care for each patient.
While this model is an approach worth considering, it may not be the right fit for every market. In areas with a large number of primary care providers, it could be difficult to find patients willing to pay a membership fee on top of their insurance premiums. If a practice wants to remain independent, the direct pay model may be the best option. Practices need to analyze their current business patterns and determine what is right for them.
Although change can be difficult, it’s important that family physicians embrace the challenges ahead in order to provide patients with the best quality care.
Author: Lauren Daniels