It is widely accepted that the U.S. health care system, although touted by some as the “best system in the world,” has room for improvement. Many people have no regular health care provider. Care is often fragmented and lacks coordination, which compromises quality and efficiency. Incentives for providers have not caught up with the demographics of chronic care. Some 75 percent of Medicare spending is on beneficiaries with five or more chronic conditions – and those people see an average of 14 different physicians a year.
Medicare demonstration projects and private sector initiatives are testing models that promise to improve health outcomes, decrease health disparities and enhance patient experience. These are patient-centered primary care models referred to as “medical homes,” which are designed to manage chronic care and realign incentives.
Can health care be refocused from acute care services to the management of chronic conditions? Is payment reform the first step in restructuring health care delivery? What part can private integrated delivery systems play? Are different models needed in large group practices and smaller ones? What challenges face policymakers in the current climate of health care reform?
To address these and related questions, the Alliance for Health Reform and The Commonwealth Fund sponsored a September 22 briefing. Panelists were: Robert Berenson, Urban Institute; Diane Rittenhouse, University of California San Francisco; and Duane Davis, Geisinger Health System. Melinda Abrams of Commonwealth and Ed Howard of the Alliance co-moderated.
Full Transcript (Adobe Acrobat PDF)