Viability of Primary Care

1. Viability of Primary Care Daniel B. Michael, MD, PhD, President Michigan State Medical Society

2. Profile of Michigan Current Physicians (MDCH study) Most Michigan physicians are actively engaged in the practice of medicine or in a closely related activity such as medical research, medical administration, or medical teaching Approximately 1/3 of all Michigan physicians provide primary care services in family practice, internal medicine, pediatrics, & ob/gyn

3. Overall Physician Shortage in Michigan Two recent studies (MSMS & MI universities) shows potential shortage of 4,000 - 6,000 physicians by 2020 Shortage of primary care physicians looming, especially family practice, general practice and ob/gyns as current physicians retire or change careers An MSMS strategic goal this year is to focus on viability of primary care

4. PRIMARY CARE EFFORTS Physician collaboration aimed at supporting primary care: Michigan State Medical Society Michigan Chapter of the American Academy of Pediatrics Michigan Chapter of the American College of Physicians Michigan Osteopathic Association Michigan Academy of Family Physicians

5. COLLABORATIVE PRODUCTS TO DATE A publication documenting the success of the Kent County Pediatric Patient Centered Medical Home project (due in November) PCMH Case Studies and a conference highlighting the innovative and successful practices – Nov. 3, Ann Arbor A payer “crosswalk” has been developed with the assistance of the Medical Advantage Group to assist physicians in determining which payers are reimbursing which PCMH areas

6. COLLABORATIVE PRODUCTS TO DATE Developing an educational piece, survey and forum about primary care and the PCMH for candidates running for elected office this fall The collaboration has the momentum to provide valuable resources to all Michigan physicians The group will continue to meet to discuss primary care health care delivery and legislative advocacy

7. MEDICAID FUNDING CRUCIAL TO PRIMARY CARE ACCESS Looking at long-term solutions to Medicaid funding Longtime goal of MSMS is Medicaid rates on par with Medicare

8. Keep Physicians in Michigan Coalition Coalition includes MSMS and many specialty societies Equitable and sustainable funding for MI Medicaid Medical school debt forgiveness Preserve nation-leading tort reform (especially important for ob/gyns) Creative approaches to connect medical students and residents to underserved areas in Michigan

9. Other Activities in Michigan Michigan Primary Care Consortium All Payer Demonstration Projects PGIP and other PCMH payer incentives State of Michigan loan repayment program

10. Federal Health Care Reform Legislation Provides a 10% Medicare bonus payment to primary care physicians (and general surgeons) practicing in health professional shortage areas. Effective 2011 through 2015 Establish Teaching Health Centers to provide payments for primary care residency programs in community-based ambulatory patient care centers (2011) Allow providers organized as accountable care organizations (ACOs) that voluntarily meet quality thresholds to share in the cost savings they achieve for the Medicare program (2011) Increase Medicaid payments for primary care services provided by primary care doctors for 2013 and 2014 with 100% federal funding

11. MSMS PCMH Conference The Realities of the Patient Centered Medical Home – Case Studies Wednesday, November 3, 8:30 a.m – 3:30 p.m. Ann Arbor, Four Points Sheraton Register at www.msms.org under “Education” tab