This policy brief from the Center for Health Care Strategies describes the challenges faced by small group primary care practices to improve health care quality and outcomes.    Based on a three-year project funded by the Robert Wood Johnson foundation, Reducing Disparities at the Practice Site, working with Medicaid programs in Michigan, North Carolina, Oklahoma, and Pennsylvania.  Among the lessons learned:

  • Practice leadership and practice culture are the most important – and subjective – factors for success
  • Practices needed both practice facilitation and care management support.
  • Practice facilitation was most effectively provided by an entity external to the practice with the relevant experience and skill set.
  • Receptivity to care management/coordination supports by practices was mixed, and the belief that the practices would ultimately “take over” and provide care management activities proved unrealistic.
  • Financial incentives were not the primary motivator or driver of change.
  • HIT was too overwhelming for most practices to implement to its fullest capacity.
  • Improving quality and reducing disparities in the practices will likely be more sustainable in medical home models.

Link to Original Source

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