Brasie: Primary care plays essential role in health

Jeffrey Brasie
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Despite enormous health care challenges among our aging and often unhealthy population, or perhaps because of those challenges, Michigan is being hailed as a national leader in fostering an innovative health care model that challenges long-held notions and traditions of patient care. In fact, it is at the center of transformative changes in service delivery that is yielding impressive patient outcome improvements.

While some would say that our health care system is misnamed and might more accurately be called a “sick care” system, primary care providers are working to turn the system to one focused on prevention and maintaining wellness. Until recently health care had evolved to become so specialized that providers were only able to focus on individual patient ailments, segmented by specific symptoms or perhaps individual body organs. Primary care providers, however, are leading the way to a new model that is turning the system on its head. They are adopting a “whole person” approach and assembling a team of practitioners who serve the patient within a “Patient Centered Medical Home.”

Supporters in the movement include Blue Cross and Blue Shield of Michigan, Health Alliance Plan, Upper Peninsula Health Plan and major Michigan employers. Michigan is one of eight states testing PCMH’s value through the Centers for Medicare and Medicaid Services in a multiyear, multipayer project.

After less than five years using the new model, primary care practices report significant improvements in the biggest health care challenges facing Michigan’s population — obesity, diabetes, hypertension and other issues that affect our aging residents in large numbers and lead to chronic, costly hospital and emergency room visits and huge costs for those who pay the bills.

For Michigan employers who shoulder health care expenses for their workforce, the cost reductions are already turning heads and the potential for additional savings is significant.

PCMH is characterized by coordinated care across all providers and settings, helping consumers navigate the increasingly complex health care system. Patients at PCMH practices are experiencing fewer hospital admissions, emergency room visits and unnecessary radiological imaging tests. As the PCMH model proliferates, Michigan’s job providers will benefit not only with lower health care expenses, but also through employees who are more productive due to fewer health problems and work absences.

When primary care providers — the foundation of our health care system — engage patients in their care and are accountable for its quality, the incidence of disease-specific mortality declines. A PCMH team may include any health care provider relevant to the patient’s health issues.

“The total Medicare expenditure side actually grew at a slower rate for patients who received care from a medical home versus not,” notes a report in the national journal Health Services Research.

As Michigan residents access health care services, they should ask for and expect to be part of a patient-centered medical home practice through a primary care provider. Fostering their own individual health and wellness should be their priority, along with being part of the revolution that will improve Michigan’s health status overall.

Jeffrey Brasie, MA, is executive director of the Michigan Primary Care Consortium, a nonprofit.

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