Transcript Melinda Abrams Presentation - Alliance for Health Reform

1
THE
COMMONWEALTH
FUND
Innovations in Primary Care:
What’s In the Affordable Care Act?
Melinda Abrams, MS
The Commonwealth Fund
www.commonwealthfund.org
Alliance for Health Reform Briefing
December 13, 2010
2
Primary Care Foundation At Risk
• Strong primary care base critical to achieve high performance
• Patients not receiving timely, efficient care
– Half of all adults report problems obtaining access to primary care
– Two-thirds of U.S. adults report problems with coordination of care
– One in five chronically ill adults say they visited the ER for care they
could have received from primary care clinician
• Primary care practitioners report difficult practice environment
– 58 percent of primary care physicians report that their patients have
difficulty paying for medications or care
– Only 46 percent of physicians report using electronic health records
– Almost half of U.S. primary care physicians work in small practices
– Reimbursement system biased in favor of procedures
– Primary care physicians earn 54 percent of specialist physicians
– Only 7 percent of 4th year medical students choosing primary
care
THE
COMMONWEALTH
FUND
2
3
Affordable Care Act: Investing in Primary Care
1. Changing Payment and Financial Incentives to Promote Primary Care
–
Medicare 10% primary care bonus, 2011-2016
–
Medicaid primary care reimbursement increased to Medicare levels, 2013-134
–
Incentives for patients to obtain preventive care
2. Testing and Spreading Innovative Ways to Deliver Primary Care
–
State option to enhance reimbursement to primary care practices for Medicaid
patients with chronic conditions
–
Innovation Center: medical home pilots a priority
–
Grants/contracts to build capacity of medical homes:
•
Community-based collaborative care networks for low-income patients
•
Community Health Teams increasing access to coordinated care
•
Primary Care Extension Center program
3. Ensuring Adequate Supply of Primary Care Providers
–
Scholarships, loan repayment and training demonstration programs to invest in
primary care physicians, mid-level providers and community providers
–
$11 billion for Federally Qualified Health Centers 2011-2015 to serve
15 million more patients by 2015
THE
COMMONWEALTH
FUND
4
Objectives of This Briefing
•
Primary care critical to improving quality, lowering cost
•
Affordable Care Act of 2010
– Many provisions will improve access, coordination, efficiency,
patient experience, cost-savings
– Taken together, put us on a path to high performance
•
Many states have a started to strengthen primary care
– Much to learn from their lessons, challenges
•
Importance of multiple payers working together
– Medicare and Medicaid
– Public and private
THE
COMMONWEALTH
FUND
5
Acknowledgements
Rachel Nuzum
Assistant Vice President,
Federal Health Policy
Stephanie Mika
Associate Policy Officer,
Federal Health Policy
Georgette Lawlor
Program Associate,
Patient-Centered Coordinated Care
Visit the Fund at:
www.commonwealthfund.org
THE
COMMONWEALTH
FUND