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Home Research Research Library Advancing Primary Care Through Alternative Payment Models: Lessons from the United States & Canada Advancing Primary Care Through Alternative Payment Models: Lessons from the United States & Canada 2018 Author(s) Bazemore, Andrew W, Phillips, Robert L, Glazier, R H, and Tepper, J Topic(s) Role of Primary Care Keyword(s) Payment Volume Journal of the American Board of Family Medicine Source Journal of the American Board of Family Medicine The United States and Canada share high costs, poor health system performance, and challenges to the transformation of primary care, in part due to the limitations of their fee-for-service payment models. Rapidly advancing alternative payment models (APMs) in both countries promise better support for the essential tasks of primary care. These include interdisciplinary teams, care coordination, self-management support, and ongoing communication. This article reviews learnings from a 2017 binational symposium of 150 experts in policy and research that included a discussion of ongoing APM experiments in the United States and Canada. Discussions ranged from APM challenges and successes to their real and potential impact on primary care. The gathering yielded many lessons for policy makers, payors, researchers, and providers. Experts lauded recent APM experimentation on both sides of the border, while cautioning against the risk of “pilotitis,” or developing, implementing, and evaluating new payment models without plan or ability scale them into broader practice. Discussants highlighted the power of “learning at scale,” highlighting large-scale primary care payment innovations launched by the US Center for Medicare and Medicaid Innovation since 2011, and called for a similar national center to drive innovation across provincial health systems in Canada. There was general consensus that altering payment models alone, absent incentives for innovation and continuous learning as well as increased proportional spending on primary care overall, would not correct health system deficiencies. Participants lamented the absence of more robust evaluation of APM successes and shortcomings, as well as more rapid release of results to accelerate further innovation. They also highlighted the importance of APMs that include flexible and upfront payments for primary care innovations, and which reward measuring and achieving global rather than intermediate outcomes, to achieve utilization goals and patient and provider satisfaction. ABFM Research Read all 2003 Computer-based testing in family practice certification and recertification Go to Computer-based testing in family practice certification and recertification 2013 The redistribution of graduate medical education positions in 2005 failed to boost primary care or rural training Go to The redistribution of graduate medical education positions in 2005 failed to boost primary care or rural training 2014 Tectonic shifts are needed in graduate medical education to ensure today’s trainees are prepared to practice as tomorrow’s physicians Go to Tectonic shifts are needed in graduate medical education to ensure today’s trainees are prepared to practice as tomorrow’s physicians 2020 The Impact of Practicing Obstetrics on Burnout Among Early-Career Family Physicians Go to The Impact of Practicing Obstetrics on Burnout Among Early-Career Family Physicians
Author(s) Bazemore, Andrew W, Phillips, Robert L, Glazier, R H, and Tepper, J Topic(s) Role of Primary Care Keyword(s) Payment Volume Journal of the American Board of Family Medicine Source Journal of the American Board of Family Medicine
ABFM Research Read all 2003 Computer-based testing in family practice certification and recertification Go to Computer-based testing in family practice certification and recertification 2013 The redistribution of graduate medical education positions in 2005 failed to boost primary care or rural training Go to The redistribution of graduate medical education positions in 2005 failed to boost primary care or rural training 2014 Tectonic shifts are needed in graduate medical education to ensure today’s trainees are prepared to practice as tomorrow’s physicians Go to Tectonic shifts are needed in graduate medical education to ensure today’s trainees are prepared to practice as tomorrow’s physicians 2020 The Impact of Practicing Obstetrics on Burnout Among Early-Career Family Physicians Go to The Impact of Practicing Obstetrics on Burnout Among Early-Career Family Physicians
2003 Computer-based testing in family practice certification and recertification Go to Computer-based testing in family practice certification and recertification
2013 The redistribution of graduate medical education positions in 2005 failed to boost primary care or rural training Go to The redistribution of graduate medical education positions in 2005 failed to boost primary care or rural training
2014 Tectonic shifts are needed in graduate medical education to ensure today’s trainees are prepared to practice as tomorrow’s physicians Go to Tectonic shifts are needed in graduate medical education to ensure today’s trainees are prepared to practice as tomorrow’s physicians
2020 The Impact of Practicing Obstetrics on Burnout Among Early-Career Family Physicians Go to The Impact of Practicing Obstetrics on Burnout Among Early-Career Family Physicians