Brian’s Note: This comment was salient enough that I thought it warranted its own post.
What has slowly emerged during this period of “undermining the financial integrity of the medical practice” – particularly primary care – has been a series of “collectively ignorant” strategies attempting to pay less for individual services, not spend less in the aggregate. Why? Because, for those who have controlled the conversation, which has never really included primary care or the patient, reducing spending in the aggregate has not been in their “enlightened self interest.”
Having successfully taken 12 “independent” primary care practices through the PCMH recognition process both in Michigan and upstate New York, I have seen primary care physicians become re-energized about the prospects of restoring both value and meaningful revenue to and for their efforts to effectively “manage” their patients in a way that ultimately makes them less costly to insure, but more importantly, less costly to employ. That being said, it truly must be the employer, both public and private, that partners with primary care and patients in more creative and innovative ways that includes developing an improved understanding of primary care services and programming for the entire population not just for those with diagnosed conditions.
In addition, I for one believe that if we can successfully restore value to those primary care practices capable of demonstrating performance we can also restate the value of those specialists, hospitals and ancillary providers who support them by creating an environment whereby the primary care physician can clearly document and report that value. It is only when we recognize this positioning in the delivery of meaningful, sustainable and affordable healthcare will we consistently get it right. True population health improvement begins “one patient at a time.” Investing in and enhancing primary care is the right direction – finally.