I have been following the Patient Centered Medical Home movement for some time. The promise of “Advanced Primary Care” is that patients (clients/consumers/customers) will, by virtue of access to such care, be healthier. Although this sounds “pie in the sky”, there is good evidence that utilization of health care resources is moved from the Emergency Department to the primary care office (where chronic illness care and preventive services are also delivered), hospitalizations for primary care sensitive conditions (such as asthma) are reduced, and patients are more satisfied with their care. Additionally, the total costs of health care are reduced in systems which have instituted such a delivery system.

Earlier this week, IBM took the next step. They announced that they would fund 100% of primary care visits (no co-pay) to encourage utilization of primary care by the employees and their families. In a statement the company said “”This new approach advances IBM’s advocacy of wellness, preventative and
primary care — the cornerstone of keeping people healthy and productive,”
said Randy MacDonald, IBM senior vice president, Human Resources.  “As a
result of our focus on wellness and primary care, IBM employees have become
healthier and our costs are rising more slowly.”

In Mobile, Alabama, the University of South Alabama Medical Center had 380 admissions  (32% of all admissions) for “ambulatory sensitive conditions” in 2007. 1/4 of these spent time in the ICU.  This is despite the presence of 3 community health centers (25% charge for primary care if you are uninsured), the resources of the University, and the resources of the community. Maybe we need to take a lesson from IBM.