The new ways of delivering health care

Because new payment models require effective and seamless care coordination among providers, new methods of delivering care have also been experiments in the living laboratory. Two in particular have become especially prominent.

Medical homes

“A primary care medical home, or PCMH, is an arrangement in which a primary care physician or group accepts accountability for most of the care being provided to their patients,” explains Bill Kramer, executive director for national health policy at the Pacific Business Group on Health. “The purpose is to encourage greater coordination between primary care physicians and the specialists a person might need. There are many different models that have been tested; some are focused on general patients, and some are focused on patients with multiple chronic conditions and have high risks for visits to specialists and emergency rooms. The payment models vary. Some simply build on fee-for-service but pay an extra amount for care coordination; this is usually combined with bonuses for high quality outcomes. Others are structured as a partial capitation. And for primary care and certain specialty services, they might or might not be responsible for hospital care.”