As the healthcare industry continues to change and consolidate, it’s increasingly important for family physicians to embrace comprehensive patient-centered care through technology and data exchange. Through cooperation and community involvement, physicians can find new and effective solutions for the many challenges ahead.
Improving Healthcare with the Patient-Centered Medical Home
Through the patient-centered medical home model (PCMH), family physicians provide coordinated care for their patients in a multidisciplinary healthcare system, the end goal being to improve patient outcomes and reduce costs. There is a shortage of family physicians and financial incentives haven’t yet aligned, and so reaching this goal is a challenge.
Some payers have established bonus payments for PCMH participants. However, physicians’ family practices 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.
The PCMH model is currently being evaluated in its efficacy to lead to the promised healthcare cost reductions. Established medical homes across the country have been successful but other research has called these savings into question. 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, interoperability among Electronic Health Records (EHR) systems remains a challenge for collaborative care on a larger scale.
Capitation Vs. Fee-For-Service Payment Models
Many physicians in family practices are also looking for payment models that can relieve some of the administrative burdens tied to Fee-For-Service (FFS) payments. People often look to capitation as an alternative to FFS. Capitation is a quality-based model, intended to provide incentives for better health care while fostering greater efficiency and cost-control. By charging based on quality than the number of procedures, healthcare has an incentive to deliver effective care that keeps the patients healthy and enrolled.
While Capitation is an approach worth considering, it may not be the right fit for every market. In California, where the population is higher, some providers may receive relatively low capitation rates, which in turn forces them to contract with FFS methods in addition to capitation. If a practice wants to remain independent, the direct pay model may be the best option. Practices need to analyze their current business patterns To create, maintain, and grow a practice, it’s important to weigh the options of different payment models and determine what works best.
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.