Center for Health Care Strategies: Key Factors for Improving Health Care Delivery in Small Primary Care Practices

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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