Posted by: AtlasMD

September 24, 2015

Medical Economics: The Rise and Fall of the Patient-Centered Medical Home.


On paper the idea of a patient centered medical home (PCMH) sounded great. But it’s gotten so bogged down with red tape that the only thing sticking to it is doubt. At least that’s the case for PCMH early adopter John L. Bender, MD, who recently contributed his perspective to Medical Economics.

“This year I am considering not maintaining PCMH recognition. It is basically a marketplace decision. The payments from insurers to maintain my care coordinators on payroll, to continue externally reporting from my large data registry, and all the other trappings of robust PCMH just are not sufficient.”

Dr. Bender is well aware of the rise of Direct Primary Care, but he has his doubts about that, too. He warns that you don’t want to be the first, or the last to adopt a new payment model. We might argue that at this point you’ll be neither, indeed. The payment structure is working brilliantly for DPC clinics around the country, and continues to adapt to the flexibility needs of patients. Maybe its success is partially to blame for its “cult following!”

But there’s another point Dr. Bender mentioned that we’d like to address. “Whether DPC will create a reduced standard in the delivery of healthcare quality remains to be seen, and the concern for quality is perhaps the largest hurdle DPC must overcome.”

We’ll go ahead and speak on behalf of the DPC community when we say – Challenge Accepted! We know DPC presents a lot of opportunities for us, as healthcare providers, to live the life we want while providing the kind of care we always imagined – while at the same time avoiding bureaucratic policies that seem to do little more than add paperwork to the stack at the end of the day. And we didn’t go to medical school to fill out paperwork…

So we’ll press on in hopes of proving to Dr. Bender that quality is the very pinnacle of what we wake up to do every day. We make ourselves available to our patients nearly 24/7, and via nearly every communication outlet available (Skype chat, anyone?). We’ll continue to make house calls as needed, and go above and beyond to save our patients money at every turn of the bend, including on medications and procedures. We’ll develop relationships with our local medical communities to negotiate the best deals possible on external procedures like labs. We’ll continue to use our spare time to sit extra minutes with patients during their appointments, do extra research to help with their preventative care, and further spread the concept of Direct Care to everyone who will listen. We’ll continue to walk patients through their invoices line by line if they want, explaining exactly where each cost comes from (they’ll continue to not be surprised, though, because they typically know the cost in advance!).

We hope not only patients, but other physicians considering a transition to Direct Care will continue to see the value in our business model. It might seem too good to be true, but there are practices all over the country who are living proof of its validity.

Women’s Health Works Better When Doctors Are Motivated To Inquire

Women are often considered drivers for healthcare in their families.

Unfortunately, Kaiser Family Foundation performed a study and found that many women face cost and logistical barriers to obtaining healthcare for themselves.

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Think Like A Business! High-Deductible Plans Will Decrease Healthcare Spending.

High-deductible health plans appeared after legislation was passed in 2003 that required persons opening a health savings account to enroll in a high-deductible plan. They gained prominence recently as employers watched their own healthcare spending skyrocket.

And in 2013, the U.S. Department of Health and Human Services reported that healthcare spending had grown at a record low pace from 2009 to 2011.

However, in this new HSA environment, practices need to think more like a business.

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Our Best Med Schools Are Producing The Fewest Primary Care Physicians

Our Best Med Schools Are Producing The Fewest Primary Care Physicians

The list is out. Medical Economics compiled the 20 schools producing the fewest primary care physicians. Yes, this is a worst-of list. And yes, we’re still optimists. But we’re also realistic. These “poor-producing” schools are actually some of the best in the nation. Johns Hopkins University School of Medicine, Duke University, Yale-New Haven Hospital stand out on an uber-prestigious list. It looks like our finest institutions are preparing our brightest young minds to do anything but good old-fashioned family medicine. And that is a bit disappointing.

Check out the complete list of schools on Medical Economics website.

Why Are Doctors Divorcing Their EMR?

folrb8zb22vh7mstm55jSo what’s driving dissatisfaction with EMR? While surveys document dissatisfaction among physicians, experts advise on the costs of doing so in a new article from Medical Economics. The statistics are sobering and have been validated by multiple surveys.

In the post, MGMA Healthcare Consulting Group’s Derek Kosiorek says, “This is an odd point in history, where we have asked physicians to take processes they have done their entire professional career and change them. We are taking the paper chart and every piece of information in that paper chart and we are shuffling it up like a deck of cards and putting it on a computer screen in different places.”

Nice job, Derek. We couldn’t have put it better ourselves. Check out the complete article below. The data’s eye-opening and writer Daniel R. Verdon includes sound advice for doctors looking to marry an EMR with their practice.

More Reading
“EHR divorce: What’s driving dissatisfaction?” | Medical Economics
Photo of Derek Kosiorek (@kosiorekcourtesy of Twitter