Despite years of discussion and research, formalized care coordination is a relatively new concept for primary care practices. Measurement criteria for care coordination are emerging, but we are still watching the earliest stages of its evolution. It will be some time before the elements for success in care coordination are quantified on a broad scale, but the foundation has been laid for pilots and early adopters to educate and inform the greater primary care community in the years to come.
For decades, employers have been among the first to test the waters in new health care design, implementing creative employee benefit structures in an effort to improve the value of health care delivered to employees—in effect, to balance the quality and cost equation. In recent years, many employers have embraced advanced primary care models and the patient-centered medical home (PCMH) in their latest efforts to improve value; some employers are successfully linking value-based benefit design in those innovative programs.
In recent years, public and private employers have experimented with numerous strategies to achieve dual objectives of controlling costs and improving employee health. Two widely discussed innovations are value-based insurance design (VBID) and the patient-centered medical home (medical home). Both approaches have been written about extensively, and research is emerging on their effectiveness at optimizing clinical outcomes and restraining cost growth.
The need to tame health care costs, while improving quality in the employer and purchaser settings has become an imperative for businesses, consumer groups, and municipalities throughout the United States. It is now clearer than ever that the only way to address the ills that afflict our U.S. health care system is through truly transformative change in health care financing and delivery.
Dozens of medical home demonstration projects across the country are exploring ways to implement better care coordination, meaningful use of health information technology, better communication access between patients and providers and a team approach to care. But efforts to transform health care delivery depend heavily on introducing sustainable new models to finance the medical home. Without changing the way health care is purchased, providers will have no incentive to move away from a system that promotes health care volume to one that rewards health care value.
