TTA Archives 2005-2012

In the US, one of the major problems in the healthcare system has been a growing shortage of generally low-paid primary care physicians (PCPs) and the broken economics of practice in a fee-for-service (and liability avoidance-driven) system. The theory behind the ‘patient centered medical home’ (PCMH) is to revive (and better compensate) PCPs by making them the locus of coordinated patient care, mainly driven by insurers desiring cost savings. This Forbes article is quite contrarian in stating that PCPs will be experiencing a veritable renaissance not only through the PCMH, but also through high-deductible policies and by one of the pieces of the ACA that permits non-insurer health plans called Direct Primary Care Medical Homes (D-PCMH) such as Qliance, Iora Health and WhiteGlove Health. However Editor Donna sees clouds in this sunny sky. Insurers are still in limited pilots for PCMH and ACO models, which vary widely. And insurers themselves are in flux–the largest are aggressively reorganizing around HIT and these models (Aetna, Optum/UnitedHealth), while others have pulled back, possibly conceding that their best outcome is merger or sale. Excellent background if you are attempting to fit your technology into practices and hospitals. (And we haven’t even touched on specialty practice or long-term care!) The author credits IBM with helping to unleash ‘Primary Care Spring’.