Why is it so difficult to get physicians to work together to coordinate care for their patients? Here’s why:
“The typical primary care physician has 229…other physicians working in 117…practices with which care must be coordinated, equivalent to an additional 99 physicians and 53 practices for every100 Medicare beneficiaries managed by the primary care physician.”
Most Medicare patients like the ability to see any doctors they choose. However, this flexibility creates significant care coordination issues. Medicare patients who are willing to sacrifice some provider choice to improve care integration, likely opt for Medicare Advantage’s managed care plans like Kaiser. In the fee-for-service world that currently exists, however, care coordination is not a simple proposition.
- Source: Pham HH, O’Malley AS, Bach PB, Saiontz-Martinez C, Schrag D. Primary care physicians’ links to other physicians through Medicare patients: the scope of care coordination. Ann Intern Med. 2009 Feb 17;150(4):236-42.
There may not be a better statistic out there to support implementation of standardized electronic health records. There is no reason Medicare should not require this of all physicians and facilities, and require MA organizations to contract only with providers who comply with this. Surely there is money to help PCPs implement this, but alas the lobbies will have everyone believe that EHRs are a pipedream and will force physicians into the destitute lifestyle somewhat near that of a Chinese migrant worker.