Primary Care by Market

This Washington Post article explains efforts in the state of Maryland to create a more cost-effective primary care system. The new system gives primary care practices financial incentives to cut their patients' total health care costs. Doctors and staff may do this by following up with a patient after appointments to ensure that he is taking medication correctly or to keep track of the emotional well being of patients with chronic illnesses. The state hopes that following up with patients will decrease trips to the hospital or emergency room and promote overall healthier lifestyles. As a financial incentive, doctors' offices will receive 50% of total patient savings. The state Medicaid program and five major insurance companies have also given $6 million to support to practices that create teams of doctors and nurses to coordinate all aspects of the primary care process, making it simpler for patients. The money is meant to help practices hire and train additional staff. These incentives are in addition to the payments that doctors already receive from patients' insurance companies. One doctor explained that coordinating various aspects of the primary care process takes a lot of effort and has never been done before because doctors have never been paid to do it. He is willing to do the extra work now that there is a financial incentive.

In the past, insurance companies have tried to take similar steps, such as calling patients to urge them to take their prescribed medication. These efforts were less successful, the article explains, because patients do not feel the same sense of trust towards their insurance companies as they do to their doctors. By coordinating all aspects of the primary care process and following up with patients, the state of Maryland believes it can make patients feel like they are being taken care of. The state hopes that this will nudge patients to live healthier lifestyles overall.