Small Practices Successfully Preventing Readmissions! by Steven Mussey MD

2015-04-21-dinosaur

We have two doctors in our Internal Medicine Practice.

That’s it!

Two.

We don’t have any “physician extenders.”  We each cover our own calls, unless one of us is out of the country or on a plane.  We enjoy our lives and we believe we do a good job.

For years, I listened to leaders in the American College of Physicians (ACP) ramble adoringly about the “Patient Centered Medical Home (PCMH). “

I grumbled.

The requirements to officially create such an entity really require a larger group.  The necessary checklist of requirements is daunting.

My message has been, instead: Our group of two doctors creates a “Patient Centered Medical Home, “ better than any concoction from the National Committee for Quality Assurance (NCQA).

Yet, it is clear the Affordable Care Act (ACA) and the NCQA is doing its best to crush little groups like us.

Finally, however, our value is getting noticed:

http://www.acpinternist.org/archives/2015/03/readmissions.htm

Bottom lines:

  • Solo or partner practices had 33% fewer hospital re-admissions than bigger groups.
  • Smaller practices do the things that should actually be happening in a “medical home.”  Unfortunately, the “medical home” is simply checking boxes without improving care.
  • Financial incentives do not reduce readmission rates.
  • Smaller practices are actually succeeding in providing an integrated care experience for the patient.

Yet everyone wants to kill us off and make us join a mega-group or organization.

“We’re dinosaurs… and I like it!” I shout after leaving a typical healthcare meeting.