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Open access scheduling. Online appointment setting. Electronic health records. Such is the stuff of the Future of Family Medicine project's new model of care.
Physicians who implement such features can increase their productivity and their compensation, says Stephen Spann, M.D., of Houston. Spann chaired FFM's Task Force 6, which was charged with studying the financial viability of the new model of care.
"But this is not just about money," said Spann. "We sincerely believe the new model will improve quality of care, patient satisfaction and physician satisfaction as well as practice financial performance."
A consultant, The Lewin Group, conducted an economic modeling exercise to illustrate the financial impact of the new model with the current pay structure. The modeling exercise was based on a typical family medicine office, comprising five FPs. Isolating 10 features from FFM recommendations that would be easy to model, Lewin predicted there would be a 26 percent increase in an FP's compensation as a result of implementing all 10. Similarly, an FP putting the 10 features in place could decrease his or her workweek by six hours and maintain the same compensation as before, said Spann, or could work the same hours as before and have the same income but gain more time for patients.
The key is to take action, said AAFP Board Chair Michael Fleming, M.D., of Shreveport, La., a member of Task Force 6.
"This doesn't mean that doctors can practice the way they've been practicing and make more money," he said. "It's going to require change. We have to make those changes on faith."
Those changes will not be painless.
According to the Task Force 6 report, the cost to transition to the new model will be anywhere from $23,442 to $90,650 per physician, depending on the loss of productivity associated with implementing an EHR system. "But the biggest investment is the willingness to change," said Fleming, who predicted that the financial benefits of the transition would be realized within a year.
Spann noted that the 26 percent increase in compensation was estimated using the current pay-for-service structure. An even larger increase could be gained from a mixed-payment structure, which the Academy has been investigating through talks with CMS and private insurers.
Task Force 6 addressed not only the microeconomic impact, the effect on individual physicians, but also the macroeconomic impact, on society. "If every patient in the country had a primary care physician and received primary care, total U.S. health care costs would be reduced 5.6 percent," based on Lewin's projections, said Spann.
The final report of the task force, published in the November/December Annals of Family Medicine, can be found at http://www.annfammed.org/.
To reach writer Toni Lapp, e-mail tlapp@aafp.org.
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Copyright © 2004 by American Academy of Family Physicians.