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Hurdles ahead for health care reform primary care model, U-M study shows
Date:11/11/2010

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
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Contact: Ian Demsky
idemsky@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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