Most health care reform efforts center on creating a single “medical home” as a means to provide efficient, high-quality care.
Analysts at PricewaterhouseCoopers say that the ideas about how to pay for health care involves using primary care doctors as the gateway to the system — proven by many studies as the way to provide the greatest value.
“Payment reform also focuses on primary care, early intervention, preventing those costly episodes,” said Dr. David Levy, a health care analyst for PWC. “We also are going to see an increased focus on preventive services that don’t bend the cost curve.”
The focus on primary care doctors is going to converge around the patient as the center of the economic system, he said.
“Patients are going to demand the system be value driven,” he said. “People with multiple, chronic conditions are going to see one person to coordinate all their care.”
The shift to primary care will mean a change from treating chronic conditions using episodic acute care to a model of continuous care.
“Medicare enrollees with chronic conditions who have a single medical home show increased savings of $9 for every $1 spent,” he said. “There’s extreme pressure to make this happen, and it’s hard to imagine that there wouldn’t be a dash for this kind of coverage.”
But the shortage of primary care doctors will have to be addressed for this kind of reform to be successful.
“The legislation provides $500 million for medical professionals, including $200 million for nurse training programs,” Levy said. “And the Senate finance bill is focused on creating solutions to the nursing supply issue.”
But just because medical schools are graduating more doctors and nursing schools are graduating more nurses — doesn’t mean there is equal access.
“So the legislation is also going to focus on reimbursement incentives for doctors and medical professionals in rural areas,” he said. “There will be a 10 percent extra fee for primary care doctors from Medicare.”
And there will be a financial incentive to promote the use of technology to connect with patients — something the medical industry has not fully embraced.
“Fewer than 6 percent of doctors say they use e-mail to correspond with patients. And studies show that patients will embrace that type of virtual service,” Levy said. “Just look at the immediate success of WebMd. There is a $2 billion investment into electronic health records and medicine, and it is going to pay off.”
WebMD has 61 million visitors every day, providing information to people who want to learn more about their diagnosis and about their health. It’s the type of technology that can both free doctors’ time and save money.
Access to care is going to be solved in innovative ways — a combination of preventive measures, retail and worksite clinics, and using Internet and smart phone technology.
The market for telemedicine devices and services will generate $3.6 billion in annual revenue within five years, according to a study by Pike & Fischer. Both the need to control costs and advances in wireless broadband networks will fuel the growth.
“With respect to care models, we’re going to see care given in new and different ways — we’re going to see an un-jamming of the system through new partnerships, new technologies,” Levy said. “There are going to be alternative ways to access care — the Internet, phone, online forms.”