The mission of the Texas Medical Home Initiative is to ensure that every Texan has a medical home. In a state as vast and varied as Texas, we feel that the most effective way to accomplish this goal is through ongoing education and advocacy. We have held 5 successful Primary Care and Health Home Summits and through those, have reached many hundreds of health care professionals, policy makers and consumers.
However, we recognize that a once a year Summit is not sufficient to keep informed of the developments in healthcare that affect primary care. So starting now, we will be sharing useful information about practice transformation through our website.
The plan is to let you know about important developments in the literature and in the business of practice transformation by sharing links to the studies and also by offering concise summaries of the key points from the studies and reports.
More to come...
1. One of the major reports released recently is the Patient-Centered Primary Care Collaborative’s Annual Report . The report can be found here:
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:
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.
Sue Bornstein, MD, FACP is a Board-certified internist. She practiced in a small group setting in Dallas for 12 years. Sue is a graduate of the University of Texas at Austin and Texas Tech School of Medicine. She did her internal medicine residency at Baylor University Medical Center in Dallas.