Healthcare delivery systems should consider leveraging nurse practitioners and physician assistants, patient-centered medical homes, multi-disciplinary care teams, and health information technology to meet the future demands for primary care, according to a new report from UnitedHealthcare.
"There is no single set of clinical, organizational, and financial models that successfully expands primary care capacity and improves service delivery," the report's authors said in their summary. "The approaches examined in this report offer multiple complementary pathways that can be tailored to local market conditions and policy environments. When implemented successfully, their common threads include focusing on the patient; the quality of service delivery, rather than who is delivering care and in what setting; and paying for value. These approaches challenge longstanding assumptions about the scale, pace, and intensity of change that are both possible and necessary."
In one illustration of how shifting to a PCMH approach led to savings, evidence from UnitedHealthcares medical home programs in four states showed average third-year net savings of 6.2 percent of medical costs, resulting in a return on investment of 6 to 1.
The authors also reported additional "proven and scalable" approaches to expanding primary care capacity and efficiency, including leveraging clinics in large retail outlets; delivering care in patients' homes; utilizing group visits; and engaging patients with complex needs by mapping patient clinical characteristics to utilization levels and payment models that support resource-intensive targeting and care management efforts.
The full report is available here.
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