By: John Gauthier

Communications Coordinator (IHI)

“None of the things we know really matter to health is actually paid for.”

That’s the view that Dr. Kirsten Meisinger, a medical director for Cambridge Health Alliance (CHA), shared as WIHI looked at what it really takes to be a high functioning primary care practice in the United States on the October 10 program. Dr. Meisinger was joined by Dr. Ed Wagner, developer of the Chronic Care Model, and now co-directing an initiative known as LEAP (Learning from Effective Ambulatory Practices) which includes CHA’s Union Square Family Health Center and 29 other sites. This includes Harvard Vanguard Medical Associates’ Patient-Centered Medical Home in Medford, MA, whose director, Dr. Thad Schilling was also on the show along with IHI’s Senior Vice President, Trissa Torres.

The LEAP initiative, which is seeking to identify promising staffing models in primary care, is testament to how much innovation is going on with or without payment reform to match new roles and services. Dr. Torres noted that in some states better alignment is emerging and like any conversation focusing on the changing landscape of health care in the United States, the optimism of improvement and innovation overshadowed financing. Still, listener David Pittman asked, “How do you hire these people without the reimbursement being there?”

Kelly Taylor, another listener, noted that “softer savings include the cost of off-loading non-provider duties from the physician” to other parts of a care team. Kelly’s advice: “Don’t let reimbursement barriers stop you from doing this!”

Reimbursement barriers are not the only challenges primary care providers encounter when envisioning new care teams. We polled our listeners to see what else can present barriers:

Listener Robin Cook noted that, despite cost concerns, we can still change our focus to patient needs and “establishing relationships to impact the care outcomes.”

If you missed out on this WIHI, you can always find it here at our archives page, along with the chat and other resources from the program.

Our next WIHI will look at the Conversation Ready initiative, “Who’s Conversation Ready? How Health Care Can Respect End-of-Life Wishes,” and will air on Thursday, October 24th at 2:00 EST. As always, we hope you’ll tune in!