Politico Pro reports some specialty physician groups are pressing CMS for a broader definition of primary care--one they say is more consistent with the ACA's intent. Among those pushing for the change are specialists that are often considered primary care practitioners. Lobbyists for the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists have urged CMS to include them under an Affordable Care Act provision that will allow primary care doctors to receive Medicare-level rates when they treat Medicaid patients. (Kaiser Health News )
Effect of Clinical Decision-Support Systems: A Systematic Review, an AHRQ-funded article, found clinical decision support systems (CDSS) are effective in improving health care process measures across diverse settings but that limited evidence is available about the impact on clinical and economic outcome measures. This article expands on AHRQ's Enabling Health Care Decisionmaking through Health Information Technology, which discusses keys to successful implementation of CDSSs. (Annals of Internal Medicine; Enabling Health Care Decisionmaking through Health Information Technology)
GOP health care plan in the works
Lawmakers say a Republican plan would focus on controlling health care costs and allowing people to retain coverage while changing jobs. It will avoid President Obama's comprehensive approach to extend coverage to 32 million uninsured Americans. The aim is to lay out a prospective agenda for the newly elected political leadership in 2013, by proposing separate bills, Reuters reports. If the Supreme Court strikes down the entire law, Republicans could try to salvage some of the Affordable Care Act's provisions that are already in force and have proved popular with voters. (Reuters)
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Providers & Suppliers
In "Integrating Clinical Pharmacy into the Medical Home Model: Solving a Medication Use Crisis," Anthony Morreale, PharmD, director of the VA pharmacist services, says the pharmacist's role as medication expert is integral to team-based care's success. "Providers often struggle with time and knowledge gaps inherent to managing patients on a large number of medications with resultant side effects, drug interactions and unique patient dosing requirements," he writes in Medical Home News. "Arguably, the best trained member of the team to help fill that need as the medication expert and chronic disease therapy manager is the Clinical Pharmacist." (Medical Home News; payment required)
Survey reveals barriers to HIE
A survey released by the National eHealth Collaborative identifies the top barriers to health information exchange. Sixty-one percent of respondents cited challenges related to funding and sustainability; 53 percent cited challenges related to interoperability standards. Asked to identify the most important benefits of HIE, 73 percent cited better care coordination and 65 percent cited the ability to provide health care providers and patients with the right information at the right time. (Modern Healthcare; iHealthBeat; the survey)
ACP speaker: Be part of a PCMH John H. O'Neill Jr., DO, FACP, vice chairman of the American College of Physicians Medical Practice and Quality Committee, speaking at the ACP annual meeting, offered several tips, tactics and strategies for small practices. Among them: Consider becoming a medical home and think about using mid-level providers in your practice; they can generate additional revenue. (Medical Economics ) |
Transformation in Practice
Geriatric groups work to avoid medication problems in the elderly
Overmedication or inappropriate prescribing of drugs for the elderly is a serious public health problem. An interdisciplinary panel of 11 geriatric care and pharmacology experts has updated the so-called Beers Criteria, guidelines long-used to minimize drug-related disasters in the elderly, reports the New York Times' Well blog. The team reviewed more than 2,000 studies of drugs prescribed for older adults, highlighted 53 potentially inappropriate medications or classes of medication and categorized them as drugs to avoid in general in the elderly; drugs to avoid in older people with certain diseases and syndromes; and drugs to use with caution in the elderly if acceptable alternatives exist. (New York Times Well blog)
The Hawaii Island Beacon Community is spearheading a practice redesign program for up to 30 independent primary care physician practices into patient-centered medical homes. The program will use a curriculum developed by TransforMED to share best practices in redesign, and tailored to the needs of local physicians, according to Susan Hunt, project director and CEO of theHIBC. The program "aims to help physicians fast-track the transformation of their primary care practices at no charge." (Government Health IT)
As the Arab Spring rocked the world, Primary Care Spring is rocking the health care world, David Chase writes in Forbes. "Perhaps as unlikely as a street vendor catalyzing the Arab Spring, a catalyst for the Primary Care Spring was IBM." At the heart of their effort is the patient-centered medical home, led by Dr. Paul Grundy. The results so far have been impressive. The upshot: healthier patients who spend less time at health care providers and physicians who spend more time in patient care and less time coding billing forms. (Forbes)
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The Expanding PCMH: News and Updates
Central Georgia Health System and the Medical Center of Central Georgia are expanding collaborative agreements with regional health care agencies. They have agreed to create "regional care integrated services network" with Tift Regional Medical Center in Tifton, Ga., and are considering developing a regional patient-centered medical home. (Warner Robins Patriot)
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PCMH Multi-mediaGawande on patient safety: Change from being cowboys to pit crewsAtul Gawande, MD, speaks about South Carolina's one-of-a-kind project to implement his Safe Surgery Checklist in hospitals statewide. He also talked about the future of safer care via a vision for system re-engineering that emphasizes the patient at the center of care. The project began 18 months ago with a goal to measurably reduce surgery-related deaths and complications. "The backdrop is learning how to become more like a system of care," Gawande says of his surgery colleagues. "I call it going from cowboys to pit crews for patients...to be working as a team, incorporating evidence for best care, to solve the problems of the patient--because they are most important.". (YouTube)
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MarketVoices...quotes worth reading
"Patients have different priorities, and we need to respect that [and] develop research which allows patients to really make those decisions that are based on outcome measures that are relevant to them."
-- Anne Beal, MD, MPH, PCORI's chief operating officer, quoted in Medscape Medical News
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Link to current events, reports and news from the Patient-Centered Primary Care Collaborative (PCPCC)
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