[September 30, 2014] |
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Report: Practical and Scalable Solutions Can Overcome Worsening Shortage of Primary Care Access and Capacity, Improve Service Delivery
WASHINGTON --(Business Wire)--
With 50 million Americans lacking adequate access to primary care - a
shortfall set to worsen in coming years - UnitedHealth Group's (NYSE:
UNH) Center for Health Reform & Modernization issued a report today
highlighting practical and scalable solutions that can increase primary
care capacity and access to needed services, and improve care delivery.
In the report "Advancing Primary Care Delivery: Practical, Proven and
Scalable Approaches," new research shows a clear relationship between
more primary care physicians practicing in a local health care market
and lower rates of avoidable hospital admissions and emergency
department visits. However, even with an aging and sicker population and
reductions in the uninsured, primary care office visits declined between
2012 and 2013.
The report also finds that the lowest concentration of primary care
physicians occurs in areas with the lowest incomes and highest rates of
uninsured, as well as in rural areas, indicating that focusing on
physician supply alone may not address the largest gaps in primary care
capacity.
The report examines existing best practices and key solutions that - if
expanded at scale - can help close the primary care gap and improve care
delivery, including:
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Implementing innovative payment models that reward value. In
recent years, reforms that recognize the value of the care a patient
receives, rewarding physicians for their effectiveness and positive
medical outcomes, have taken root. Government programs and private
health plans should continue partnering with physicians, hospitals and
other care providers to emphasize primary care in an effort to improve
quality and reduce costs.
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Expanding the roles of nurse practitioners and physician assistants.
Primary care practices led by physicians can expand capacity by better
leveraging a diverse clinician workforce. While laws governing scope
of practice vary by state, there are opportunities to better utilize
these skilled care providers to boost capacity and improve access to
primary care.
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Assembling multidisciplinary care teams to deliver care more
efficiently. It would take 17 hours per day for a primary care
physician to provide all recommended care to a panel of 2,000 patients
- and many have larger panels than that. In addition to nurse
practitioners and physician assistants, care teams should expand the
role of medical assistants and health coaches.
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Using electronic health records and other health information
technology (HIT) to share information across the elivery system in
real time. Though HIT alone will not achieve dramatic improvements
in primary care delivery, it is an essential building block, enabling
practices to use resources as efficiently and effectively as possible.
Electronic patient health records that travel through a single,
user-friendly, interoperable system designed to share information
systemwide are critical to achieving this goal.
Since 2009, the UnitedHealth Center for Health Reform & Modernization
has released research and offered practical solutions to critical health
care challenges, drawing upon UnitedHealth Group's clinical and research
expertise, and data analytics capabilities.
"Primary care is essential to building a higher-performing health care
system that promotes personal well-being and saves consumers and
taxpayers money," said Richard Migliori, M.D., executive vice president
of Medical Affairs and Chief Medical Officer of UnitedHealth Group.
"This research shows the value of improving primary care capacity, not
only in terms of improving patients' health but also in catching
problems early, and avoiding unnecessary and costly hospital services."
"The Center for Health Reform & Modernization has identified a broad
range of practical, scalable solutions that can be tailored to local
health care markets and policy environments," said Cory Alexander,
executive vice president of External Affairs at UnitedHealth Group.
"These approaches, if embraced and adopted at scale, can meaningfully
increase primary care capacity, improve quality and reduce health care
costs."
The report identifies several examples of primary care providers that
have boosted quality and reduced costs by partnering with private and
government health plans in a "pay for value" model.
-
New evidence from UnitedHealthcare's medical home programs in four
states shows average third-year net savings of 6.2 percent of medical
costs, resulting in a return on investment of 6 to 1, largely due to a
payment model that rewards value.
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By adopting a pay for value model, WESTMED in New York increased
patient satisfaction, achieved an 8 percent reduction in emergency
department use, and saw overall reduction in health care costs for
privately insured patients.
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Similarly, Monarch in California improved physician-patient
communication, patient satisfaction, and prevention of hospital
admissions that can be avoided with more timely care - while lowering
costs for Medicare patients by more than 5 percent in just one year.
"Through more effective use of existing resources and smarter
incentives, we can bolster primary care capacity, increase access to the
underserved and improve the effectiveness of care delivery across the
health care system," said Dr. Migliori. "WESTMED and Monarch represent
successful models that can and should be scaled across the entire health
care system, acknowledging the unique needs of each payer, care
provider, patient population and policy environment of each local
market."
To read the full report, go to: http://www.unitedhealthgroup.com/reform.
About UnitedHealth Center for Health Reform & Modernization Drawing
on our internal expertise and data and extensive external experiences
and partnerships, the UnitedHealth Center for Health Reform &
Modernization analyzes key health care issues and develops innovative
policies and practical solutions for the health care challenges facing
our nation. We share this information in the U.S. and internationally
with policy-makers, academicians, researchers, providers, health plans,
employers, the public, and other key health care stakeholders. In
January 2009, UnitedHealth Group launched the UnitedHealth Center for
Health Reform & Modernization to present proven strategies to contain
costs and improve quality and care, and today, we continue to
demonstrate our commitment to health care modernization by offering
solutions based on proven policies and best practices.
For more information, visit www.unitedhealthgroup.com/reform.
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