PCMHs More Successful Than ACOs, Says Expert

At the Medical Home Summit in Philadelphia, Lisa Letourneau, MD, executive director of Maine Quality Counts, told the audience that ACOs have not had as much an impact on healthcare cost because a lot of primary care payments are still made under the old fee-for-service model.

Patient-centered medical homes and other forms of enhanced primary care can help control healthcare spending while improving quality of care — if the US reforms how it pays for primary care to stop focusing on volume over quality. But accountable care organizations may not be the best way to accomplish those goals, since they’re so rooted in the outdated fee-for-service system.

That’s the message from Lisa Letourneau, MD, executive director of Maine Quality Counts, a regional health improvement collaborative based in Manchester, Maine. Speaking on March 24 at the Medical Home Summit in Philadelphia, sponsored by Global Health Care, LLC, she warned that since the vast majority of primary care payments still are made under the old volume-based fee-for-service system, there’s “little meaningful change,” even with the advent of ACOs.

“One really needs to ask, what, if anything, is changing with payment within ACOs,” Letourneau said. “Relying on fee-for-service payments continues to emphasize volume and threatens meaningful practice change.”

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