A pilot project from the Center for Medicare & Medicaid Innovation will funnel extra cash to primary care practices from both the federal government and private insurers.
The federal government has selected seven regions across the nation to participate in the pilot program, including the Cincinnati and Dayton area in Southern Ohio. Officials with Cincinnati’s The Health Collaborative — a group of hospitals, physicians, insurers and other healthcare stakeholders — said the pilot program could bring an additional $15 million to 75 participating primary care practices in the region.
“We really view this is a game changer relative to primary care innovation and support,” said Greg Ebel, executive director of The Health Collaborative.
Here’s how the project will work: Participating primary care practices will receive an extra $20 per month per Medicare patient. In addition, five participating commercial health insurance companies have agreed to pay a similar monthly patient care fee to the practices.
The idea is that the primary care practices can use that extra cash in various ways to improve care — hire more health providers, provide more preventive care, implement systems to better manage and coordinate a patient’s care and the like.
For most participating practices, the program will bring an addition of tens of thousands of dollars per month, Ebel said.
The key to the federal government’s selection of the Cincinnati-Dayton region was the willingness of local insurers to participate in the pilot project. Ebel said five insurers are participating: Humana, Anthem, UnitedHealthcare, Medical Mutual of Ohio and HealthSpan.
Because the project has just been announced, several pieces of information aren’t yet clear, including the criteria for selecting primary care practices that will participate and how those practices will be measured in terms of quality and patient outcomes once they are selected.
The application process is expected to begin this summer, according to The Health Collaborative.
Among the six other geographical regions selected for participation in the project, four will happen across entire states: Arkansas, Colorado, New Jersey and Oregon. The other two regions are the Tulsa area in Oklahoma and the Hudson Valley in New York.
Boosting primary care has become a priority for the federal government and portions of the medical industry in recent years. Federal health reform (unless it’s struck down by the Supreme Court) would boost the rolls of the nation’s insured by about 30 million, creating new demand for primary care services. Plus, the U.S. is expected to face a shortage of about 30,000 primary care doctors by 2015, The Washington Post reported.
Increasing payments to primary care doctors may be a good way to address the problem. Primary care doctors are typically paid much less than specialists, and the result is that medical students facing huge student-loan debt upon graduation often view primary care less favorably than other areas of medicine.