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CMS PPACA PCMH in FQHCs saved no $

September 2, 2015
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Let me translate the title. The Center for Medicare and Medicaid Services was directed by the Patient Protection and Affordable Care Act (Obamacare) to implement the Patient Centered Medical Home model in 500 Federally Qualified Health Centers. It didn’t work.

The rationale was the usual mixture of “care coordination,” primary care doctors as “quarterbacks” (not care givers), who were supposed to use tools such as “patient-tracking software.” An analysis by the RAND corporation  observed that this resulted in understaffed clinics spending significant time filing reports, participating in conference calls, and listening to webinars instead of caring for patients. Not only did the experiment not work, they actually observed an increase in utilization and costs.

Lots of reasons were offered as to why this happened. My opinion is that besides all of the wasteful baggage of a PCMH, the doctors nor the patients were given absolutely no incentive to change anything about their care (doctors) or their expectations (patients). The deeper problem is that the bureaucrats who come up with this stuff have no real understanding of how family physicians deliver better care at a lower cost. This is getting old, but I betcha the talking heads have not finished clinging on to the PCMH as the way forward.

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One Response to CMS PPACA PCMH in FQHCs saved no $

  1. R Watkins on September 8, 2015 at 10:17 am

    And as always, the AAFP leadership has their fingers in their ears and is chanting “we don’t hear you.”

    Their continuing unquestioning, anti-intellectual devotion to the misbegotten PCMH has become both embarrassing and indefensible.

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