Newspaper article The Florida Times Union

PRIMARY CARE; A Revival Is Needed

Newspaper article The Florida Times Union

PRIMARY CARE; A Revival Is Needed

Article excerpt

If Florida is to get a handle on skyrocketing Medicaid costs, the state can do it efficiently.

Just target the 5 percent of the users who use about 50 percent of the services.

They often have several diseases and mental health issues.

These patients require a relationship with a physician to keep their illnesses under control.

The best way to do that is to reinvest in primary care doctors.

So, for instance, it ought to be used in areas with large numbers of Medicaid patients, as in Duval County.

A proposal before the Florida Legislature would set up a pilot Florida Medical Home Program.

PILOT PROGRAM

The advocates are part of the Florida Primary Care Coalition, composed of the Florida Academy of Family Physicians, based in Jacksonville, as well as the Florida Association of Community Health Centers and the Florida Osteopathic Medical Association.

"Florida does not currently have a strategy to control health care costs, ensure greater access and move the state toward more positive and lasting outcomes," reported the three medical associations in their proposal."

The pilot is based on about an 8 percent savings per patient enrolled in the program.

Amazingly, the medical associations say, Florida is not using primary care as the anchor of the health care system. Without that anchor, the emergency room turns into the main option, a costly one.

A key to the medical home model is to move from fee-for-service systems to paying primary care providers based on visits and outcomes rather than for procedures.

Bonuses would be paid to the primary care providers for reaching better outcomes.

Pay for outcomes simply returns us to a focus on the patient.

The associations say that using the medical home model statewide could save anywhere from $200 million to $900 million.

One study from a Seattle consulting group documented a reduction of emergency room visits of 29 percent with a medical home model. …

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