Primary Care Flashcards
What is primary care?
It includes health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis, and treatment of acute and chronic illnesses in a variety of settings
Encompasses family medicine, internal medicine, geriatrics, and pediatrics
What proportion of adults don’t see primary care providers at all?
46%
What is the main reason for primary cares major shift in the 1980s?
Increased competition due to managed care
Physicians now have to reduce fees and accept more enrollees
What are the two types of integration?
Horizontal integration & vertical integration
What is horizontal integration? Give examples
Providers merge with the same level of providers, possibly with different specialization (ex. Multi speciality group practice)
What is vertical integration? Gives examples
Providers merge with a different level of providers (ex. Integrated delivery system)
What are some of the effects of integration in primary care?
- less private practice physicians
- reduction in self employment rate in physicians
- shift from small practices to large practices
What are the models of primary care delivery?
- federally qualified health center
- patient-centered medical homes
- concierge medicine
- retail clinics
- urgent care
- accountable care organizations
What are federally qualified health centers?
- centers that emphasize preventative care, target disadvantaged patients, and receive federal funding
One stop shop
What does Section 330 of the Public Health Service act require FQHCs to have to receive funding?
- family medicine, pediatrics, OB/GYN
- diagnostics and lab services
- preventative care
- referrals and case management as needed
- behavioral health NOT REQUIRED but sometimes available
What are patient-centered medical homes?
The model offers
- coordinated care across health care and community services/support
- accessible services, like shorter wait times and more face to face with providers
- quality and safety, instituted by performance measurement
They must be accredited and approved based on scoring guidelines
What is concierge medicine?
- involves a monthly or annual retainer fee that grants special access to a physician
- concierge physicians get paid more so they can reduce amount of patients
- found substantial reductions in hospital admissions and spending
Who is more likely to opt into concierge medicine?
The wealthy
How was health care spending affected by concierge medicine?
Increase in health care spending
What are retail clinics?
Medical practices located in pharmacies, grocery stores, and “big box” stores, such as Target and Walmart
Studies show retail clinics to be a new utilization rather than a substituted utilization
