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Posts Tagged ‘ PCMH ’

More Disappointing News on the PCMH

September 6, 2017

First, I recognize that the whole PCMH experiment was not a total failure. There were some successes. The Patient Centered Primary Care Collaborative (PCPCC) puts out an annual review on PCMH demonstration sites that is always positive. On the other hand, the AAFP PCMH National Demonstration Project was mostly a failure....
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The AAFP and Payment Reform — They’re Screwing It Up, Again, Part 5 – Population Health Management

March 6, 2017

In the AAFP’s Advanced Primary Care Alternative Payment Model document, the concept of population health management is a little more muddled, but it keeps rearing its head in different places in the document with different descriptors. From the definition of the primary care medical home, the phrase Planned Care and Population...
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PCMH and Prevention Spin Using Simplistic Quality Measures

February 29, 2016

Two recent reports extoll the virtues of the Patient-Centered Medical Home (PCMH) and direct primary/concierge care. One is the annual report of the Patient-Centered Primary Care Collaborative. The other is a study of a network called MD-Value in Prevention (MDVIP). Before I continue, let me be clear that there are positives...
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CMS PPACA PCMH in FQHCs saved no $

September 2, 2015

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...
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The Cost-Effectiveness of Family Physicians – Complexity

June 16, 2013

We continue to examine the results of our recently published study on the ways family physicians deliver better care at a lower cost than a multi-ologist approach. The next concept is complexity. Family physicians are more comfortable with complexity than any other physicians, especially in their ability to negotiate the diagnostic...
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More Ignorance on the Cost-Effectiveness of Family Medicine

June 18, 2012

A normally very respectable and reliable source of healthcare observations, the Center for Studying Health System Change (CSHSC), had a bad day recently. A report by one of its fellows for the Commonwealth Fund modeled “real-world” parameters found that if primary care physicians were paid more, Medicare could save 2%. Two...
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The Limits of Care Coordination

April 15, 2012

The PCMH pushers love to talk about care coordination. They believe the key to more cost-effective care is to have primary care practices hire care coordinators to keep track of patients. I asked the leader of a large integrated network what his care coordinators actually do. He said they mostly track...
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Patient-Centered vs. System-Centered

March 4, 2012

I’ve just come back from my semi-annual renewal in my belief that family medicine is the foundational solution to make healthcare more affordable in America: the interim session of the Texas Academy of Family Physicians. The most important activity at these meetings is the networking: the chance to bounce ideas and...
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Primary Care Physicians Know U.S. Healthcare is Too Aggressive

December 11, 2011

A study in Archives of Internal Medicine surveyed a national sample of internists and family physicians about cost issues in medicine. Over 600 responded. 42% felt that most patients in their own practices receive too much care, only 6% said too little. When asked why some patients received too much care,...
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Dr. Grundy Doesn’t Quite Get It

November 20, 2010

Paul Grundy MD, MPH, FACOEM, FACPM is IBM’s Director of Healthcare, Technology and Strategic Initiatives for IBM’s Global Well Being Services and Health Benefits. He has led the development of the Patient-Centered Primary Care Collaborative www.pcpcc.net, which is leading the way to create a more efficient and responsive healthcare system. Before...
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