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Prioritize primary care this open enrollment season

Glen R. Stream, MD
Physician
November 23, 2017
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This open enrollment season, patients will be considering their health care coverage for the coming year. To ensure they are fully utilizing their primary care benefits and building relationships with health care teams that will keep them healthy, we need to encourage them to connect with a primary care practice or medical home.

A medical home is a place where a patient can seek treatment from primary care physicians and other professionals, and coordinate any needed care with sub-specialists and hospitals. It should always be the first stop — and in many cases a one-stop shop — for medical care. The primary care practice serves as a home base for medical care. It also helps patients navigate the health care system and access services in the broader medical neighborhood.

In medical homes, primary care teams consist of health care professionals who work collaboratively as “partners in care.” These teams treat traditional acute and chronic needs, but also offer behavioral and mental health services, as well as health promotion support. For example, a patient struggling with his weight would not only see a primary care physician, but could also connect with a dietician who can spend more time reviewing dietary needs and weight loss options. The teams work together toward a common goal: treating patients when they’re sick and keeping them healthy at all other times. Together, medical home staff coordinate care and support patients’ health priorities.

Utilizing primary care has real benefits for patients. For example, regular primary care improves the health of patients, as research has shown that people with primary care are less likely to suffer from cancer, heart disease or stroke. They also have higher levels of satisfaction and are less likely to receive unnecessary care. Even more, a regular primary care relationship also has financial benefits, with a recent study finding that patients who have primary care spend 30 percent less on health care than patients who don’t.

With a focus on proactive care, primary care can help prevent complications and improve both disease management and patient outcomes while reducing many of the inefficiencies characteristic of our health care system. As the health care sector continues to shift toward value-based payments for primary care, rewarding health care professionals for keeping people healthy, the trend toward proactive care will continue.

In fact, primary care physicians are able to control costs and offer better care to their patients when they receive payment that supports this team-based medical home model, rather than on the volume of care provided. Insurance programs that recognize the value of the medical home model and are open to new, innovative payment models are increasingly making differences in the lives of patients.

A health care system with a strong foundation of primary care saves money. A recent program in Oregon highlighted this well – the Patient-Centered Primary Care Home initiative saved an estimated $240 million between 2012 and 2014, achieving $13 in savings for every $1 increase in primary care spending. Results like these reinvigorate support among family physicians for team-based primary care delivered in a medical home.

This is just one example of research that continues to show that patients who are connected to a primary care practice or medical home have higher levels of satisfaction and live healthier lives.

As open enrollment begins, let us extend that access to comprehensive, continuous, quality care to more people. Connecting them with a medical home and the benefits that accompany that relationship will be the first step in making health primary.

Glen R. Stream is a family physician and president and board chair, Family Medicine for America’s Health, sponsor of Health is Primary.

Image credit: Shutterstock.com

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