Dear Readers: This was a pitch for a magazine article, so I apologize if it’s a little too wonk-y. I decided to post it here to see what other ideas you could drum up.
Quick summary: There’s an idea floating around called the Patient-Centered Medical Home–a way to integrate, automate, and improve how primary medical care is delivered in the U.S.
It has the approval of all major medical societies. A ton of money is being spent on a national demonstration project.
It’s never going to work.
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The Patient Protection and Affordable Care Act (a.k.a “Health Care Reform”) signed by President Obama in March will revolutionize Primary Care in the United States. By 2014 tens of millions of uninsured people will “enter” the system by being granted insurance, either through expansion of the Medicaid program or through mandated purchasing of insurance via state pools or the private market.
This alone will have a profound impact, straining the capacity of our already frayed system. Therefore, embedded in the law are funds to encourage growth and improvement in Primary Care: Incentives to encourage graduates to enter primary care fields (Family Medicine, Internal Medicine, and Pediatrics) and practice in underserved areas (through scholarships and loan forgiveness), and money to re-format the way that Primary Care is practiced and paid for.
The most prominent example of Primary Care restructuring is something called the Patient Centered Medical Home (PCMH). Currently a national “demonstration” project is underway to show us that the PCMH model is a sustainable way forward. The PCMH promises nothing less than greater access to primary care, delivered with improved quality and safety, better data capture and analysis, all with lower per capita costs. Devotees of the PCMH are surging ahead to tie together the twin strands of incentives for transitioning to electronic medical records and improving on the delivery and payment models of Primary Care.