1. One of the major reports released recently is the Patient-Centered Primary Care Collaborative’s Annual Report . The report can be found here: https://www.pcpcc.org/sites/default/files/resources/pcmh_evidence_es_071417%20FINAL.pdf
Dr. Russell Kohl, TMF Medical Director and member of our planning committee was one of the reviewers for the report.
This year’s report, the sixth, reviewed results from 45 peer-reviewed reports and additional government and state evaluations published in 2016. The authors state “the PCMH has demonstrated improved outcomes in terns of quality, cost and utilization, but not uniformly.” Other important findings are that the longer a practice has been transformed, and the higher the risk of the patient pool in terms of co-morbid conditions, the more significant the positive effect of practice transformation, especially in terms of cost savings.
This year’s report featured an in-depth look at the Michigan BCBS PCMH program. In its 8th year, this is one of the oldest and largest PCMH projects with 4,531 primary care physicians at 1,638 practices.
Statewide in Michigan, transformation of care has resulted in:
- 15% decrease in adult emergency department visits;
- 21% decrease in ambulatory care sensitive inpatient stays;
- decrease of $26 monthly per patient care and
- increased screening for breast, cervical and colorectal cancer.
2. One of the great challenges to practice transformation in the US is chronic underinvestment in primary care. It is estimated that only 5-7% of our healthcare spending goes to primary care, while European countries invest 12-14% of their spending in primary care.
What can be done about this inequity? The Rhode Island Insurance Commissioner used his authority to boost primary care health plan spending as a percentage of medical spending from approximately 5% in 2008 to between 8-11% in 2014. What was the result? During that time, overall health spending in Rhode Island grew more slowly than in any other northeastern state. Of note is the fact that the RI Insurance Commissioner is the one who essentially forced all the RI health plans to sit at the same table and come up with a plan for a PCMH demonstration project a number of years ago.
More recently, Oregon passed Senate Bill 934 which requires the Public Employee Benefit Board and Oregon Educators Benefit Board to spend at least 12% of total medical expenditures on primary care by 2023.
I know what you’re thinking. We live in Texas – not Michigan, Rhode Island or Oregon. But that doesn’t mean that we shouldn’t stop making the case to our policy makers and legislators that investing in primary care is the right thing to do for our great state.
Till next time.