Navigation Links
Hurdles ahead for health care reform primary care model, U-M study shows

ANN ARBOR, Mich. Provisions of new federal health care reforms will move the country toward a primary care medical home for patients, but the nation may not have enough primary care doctors to handle the workload, according to a study by the University of Michigan Health System.

Still, the concept of shifting patients to a medical home could save time and money and allow specialists to focus on complex patient care, according to the study published online ahead of print in the journal Medical Care.

"I don't think anyone would question that there are too few primary care physicians," says study lead author John M. Hollingsworth, M.D., M.S., an assistant professor of urology at the U-M Medical School. "The issue that came up in our study pertains to the role of specialist physicians in the new 'medical neighborhood.'

"Policymakers need to consider the scope and magnitude of care for which specialists are currently responsible in these delivery system reforms," he says.

Specialists spend a significant amount of time handling routine follow-up care for patients with chronic conditions that might be more cost-effectively delegated to primary care physicians.

But redistributing half of that workload could require either thousands of new primary care doctors or an extra three weeks of work a year from the primary care physicians in the current workforce, the study found.

U-M researchers examined the implications of redistributing the chronic disease care workload between specialists and primary care physicians under a patient-centered medical home model of care.

Known as PCMH, the model places an emphasis of having primary care doctors coordinate and quarterback their patients' medical care across multiple locations and settings; creating cost-savings by delegating less complex aspects of care; and shifting from an emphasis on volume under the fee-for-service model, to one that rewards the quality of the outcomes using performance measures.

The approach was an important part of the recent health care reform legislation and is becoming an increasingly popular solution to the current fragmentation and inefficiencies in the health care delivery system, the authors say.

According to the study, specialists spend a significant amount of time each year more than 650,000 work weeks collectively on routine follow-up care for patients with common chronic conditions, such as asthma, diabetes and low back pain.

Delegating a proportion of this care has the potential to create system-wide efficiencies by freeing up specialists to concentrate more on new patients and those with complex conditions.

"The cumulative time spent by specialists on routine chronic care is not trivial," says the study's senior author David C. Miller, M.D., M.P.H., an assistant professor of urology at the U-M Medical School.

"As a urologic oncologist, I take care of many cancer survivors. With a detailed care plan constructed by the treating oncologist, much of the follow-up care for these patients could potentially be assumed by a primary care physician-directed medical home, with appropriate referral back to me if problems or questions arise.

"This approach may have benefits for patients in terms of improving both coordination and access to care," Miller says.

Miller and several other study authors are affiliated with the Veteran's Affairs Ann Arbor Health Care System. The VA is one of two major federal departments that are moving toward implementing patient-center medical home reforms.

The medical home model also offers other potential benefits including less fragmentation of care, in which a patient's physicians aren't aware of what the others are doing; minimization of redundant tests and services; and more prestige and pay for primary care physicians, which may help entice more medical student to enter general medicine.


Contact: Ian Demsky
University of Michigan Health System

Related medicine news :

1. Highmark Inc. Prepares Now for the Diversity Boom Ahead
2. Nurse Practitioners Forge Ahead to Save Health Care in Maryland
3. Ivory Homes Plans Ahead for the April 30th Home Buyer Tax Credit Deadline with 100 New Homes Ready for Quick Purchase
4. Better vision ahead for many diabetic retinopathy patients
5. IAS urges donors to maintain commitment to global HIV response ahead of the G8 Summit
6. Strong scientific findings presented at AIDS 2010 point to promise ahead and underscore the need to stay the course
7. Carolinas HealthCare System Volunteers to Join Navy Rescue Mission in Haiti
8. SXC Health Solutions to Host Fiscal 2009 Fourth Quarter and Year End Results Conference Call
9. A New Website Series Improves Appearance and Health City by City
10. Diet-to-Go Welcomes 2 Key Philadelphia Fitness Centers as Partners-in-Health
11. Quantum Health Appoints Stark as Executive Vice President of Sales
Post Your Comments:
(Date:11/30/2015)... ... November 30, 2015 , ... Sikka Software announced today ... Meeting. Their Ecosystem empowers dentists to make complex business decisions by providing the tools ... receive a free fee survey with 10 procedures customized by zip code. , ...
(Date:11/30/2015)... Grove, IL (PRWEB) , ... November 30, 2015 , ... ... for an emerging pharmaceutical company. Because it is so important to this key industry ... “Success Factors in your IND Filing” on December 4th at 11am EST. , Federal ...
(Date:11/30/2015)... , ... November 30, 2015 , ... ... has verified that their Vasont Universal Integrator (VUI) extension unites with Syncro Soft’s ... and managing content as a continuous process with the latest release of oXygen® ...
(Date:11/30/2015)... California (PRWEB) , ... November 30, 2015 , ... ... a strategic alliance around Novus’ TIGR® Matrix Surgical Mesh technology for soft tissue ... synthetic polymers, TIGR® Matrix is a long-term resorbable surgical mesh intended to support ...
(Date:11/30/2015)... ... 2015 , ... Healthjump, Inc. announced that it has acquired ... development and support company. The purchase will expand the capability to serve clients ... the services currently provided by Healthjump. , Through this purchase, ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... Wash. , Nov. 30, 2015  Precision ... Post-Processing services, is pleased to announce a dramatic ... medical imaging services. Building on its ISO-9001:2008 certification ... and implemented comprehensive Core Lab protocols and procedures. ... variety of research activities.  Their Core Lab services ...
(Date:11/30/2015)... , November 30, 2015 PFE ... at up to 10 G protein-coupled receptor (GPCR) targets ... to research and develop potential new medicines directed at ... multiple therapeutic areas. --> Heptares Therapeutics ("Heptares"), ... and wholly-owned subsidiary of Sosei Group Corporation ("Sosei"; TSE ...
(Date:11/30/2015)... , November 30, 2015 Mexico Healthcare ... and Life Sciences Report 2015 . --> Pharmaboardroom releases ... . Latin America , a country of ... , a country of over 122 million people. --> ... healthcare, pharmaceuticals, or life sciences insights into the second largest pharma ...
Breaking Medicine Technology: