The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization reviews PCMH results from 45 peer-reviewed reports and additional government and state evaluations. Implementation of the PCMH and high performing primary care differs depending upon the needs and preferences of those delivering, receiving, and paying for related care.
Long-term services and supports (LTSS) include a broad range of services from nursing home care to community supports such as personal care, transportation, help with chores and maintaining a home. They provide a particularly important lifeline for older adults and individuals with disabilities or multiple chronic conditions. Access to appropriate LTSS can help people live independently, including remaining in their homes, continuing to work, and participating in their families and communities.
Primary care is a critical link in health care delivery. Often patients’ first point of contact with the health care system, primary care practitioners make decisions that broadly impact both patient health and total health care spending. This Primary Care Payment Model (PCPM) White Paper views primary care teams as uniquely positioned to serve as catalysts for innovative care as well as effective stewards of health care resources.
The Action Guide is a framework to help multi-sector groups work together to improve population health by addressing 10 interrelated elements for success and using the related resources as needed. Like a “how-to” manual, the Action Guide is organized by these 10 elements and contains definitions, recommendations, practical examples, and a range of resources to help communities achieve their shared goals and make lasting improvements in population health.
According to information from the Centers for Medicare & Medicaid Services (CMS), Comprehensive Primary Care Plus (CPC+) is a national advanced primary care medical home model that aims to strengthen primary care through a regionally-based multi-payer payment reform and care delivery transformation. The CPC+ program will offer two tracks with different payment structures and requirements.
This white paper is designed to call attention to the significant challenges facing accountable care organizations (ACOs) as they prepare for a new reality in Medicare and the rapidly evolving health care industry. ACOs represent a refined approach to the delivery of health care and were created to facilitate coordination and cooperation among providers to improve the quality of care and to reduce unnecessary costs. Although the ACO model holds great promise, Medicare ACOs are at a crossroads.
More and more attention is being paid to the social determinants of health—the conditions in which people are born, grow, work, live, and age, including factors such as income support, education, transportation, and housing—and their contribution to health and well-being. Despite all the evidence about how the factors affecting our health dwarf the impact of the health care we receive, it remains a challenge for state leaders to act. Why don’t state budgets reflect what we know about improving the health of populations?
Payment reform promises to substitute value for volume. Yet, value- and volume-based approaches typically are implemented together. All payment methods have strengths and weaknesses, and how they affect the behavior of health care providers depends on their operational design features and how they interact with benefit design. Those seeking greater value for the health care dollar are also turning to innovation in benefit design, which typically involves the implementation of more than one approach, each with its own strengths, weaknesses, and impact on consumer health care behavior.
Take a few moments right now to find, bookmark and explore a newly developed area of the AAFP's website devoted specifically to this massive MACRA effort.
