Read along with the Primary Care Review community! We’ve combed the recently published literature to choose a few select morsels worth your time. We hope you’ll agree!
Wonderful and Broken: The Complex Reality of Primary Care in the United States
Troyen Brennan’s newest book explores primary care’s struggles and emerging solutions to improve its viability. He takes a tour across the nation to share their stories of promising models that have produced on performance.
He also talks about what he learned from talking with practices to better understand the problems and struggles that they face. He finds hope in value-based care models that enable flexible care and incentivize whole-person care approaches that are built on Primary Care Medical Home chassis with extended care teams and integrated mental health services. It’s a great read and provides food for thought about how primary care can deliver with the right resources.
Annual Wellness Visits (AWVs) are an important, but underused Medicare benefit. It is estimated that half of Medicare beneficiaries don’t receive them. Research has shown that AWVs were associated with significantly reduced spending on hospital acute care and outpatient services. Patients who received an AWV in the index month experienced a 5.7% reduction in adjusted total healthcare costs over the ensuing 11 months.
There are many reasons that AWVs are underused, one of which is the additional complexity encountered when patients introduce issues that are beyond the scope of AWV design. A new article by Wellman, et. al., describes a process to improve AWV utilization which involves scheduling combined AWV and problem-based forty-minute visits with the provider that the patient most often sees. These combined appointments allow patients to complete the Medicare annual wellness visit and, if needed, have regular medical issues handled in the same visit with their regularly seen physician. Clinician education and targeted scheduling to focus on those at greatest need were also a part of the approach. When combined, the techniques markedly increased the volume of AWVs and decreased the volume of no-shows. The article offers some instructive ideas for those who are working to make AWVs a priority in their practice.
Health Policy 101: Health Care Costs and Affordability
The Kaiser Family Foundation (KFF) is a wonderful source for well-reasoned critiques and analyses about important healthcare issues of the day. Affordability has been much in the news, with healthcare premium rates increasing and the underlying cost of care on what seems to be a runaway train.
KFF has just published a piece on healthcare costs and affordability that looks at changes in healthcare spending over time, explains the tie between healthcare spending, costs, and affordability, the concerns about financial vulnerability, and provides a look at future estimated trends. It is required reading for those who want to better understand the issue of affordability and work toward constructive solutions that make care more affordable and accessible to all.
Michigan Multipayer Initiatives 