On December 15, the Commonwealth Fund released a brief examining state efforts to strengthen primary and chronic care through reorganized service delivery.  Using information from interviews with state officials and physicians in Colorado, Michigan, North Carolina, Pennsylvania, and Vermont, the authors highlight effective models to make primary and chronic care more efficient and effective.  The brief suggests that model characteristics include leadership and stakeholder input, payment incentives, and infrastructure support.  The authors also highlight the importance of certification, as well as information feedback and monitoring.

From the report:

Although most of the debate preceding the passage of the Affordable Care Act in March 2010 was focused on improving access to care, it is widely agreed that without equal attention to reforms that address cost and quality, the United States is destined to continue its path of uncontrolled, spiraling costs and poor overall performance. The issues are complex, and there is no silver bullet or panacea to solve the problems. This paper examines the roles states are playing to reorganize the delivery of primary and chronic care to produce more efficient and effective care for patients and providers, with an emphasis on small practices. The paper includes short case studies highlighting the diversity of work in Colorado, Michigan, North Carolina, Oklahoma, Pennsylvania, and Vermont, as evidence of effective policies and strategies being used to transform and link practices to improve primary and chronic care.

Full Report: Strengthening Primary and Chronic Care: State Innovations to Transform and Link Small Practices (PDF | 639 KB)

Commonwealth Fund. (2010). Strengthening primary and chronic care: state innovations to transform and link small practices. Takach, M., Gauthier, A., Sims-Kastelein, K., and Kaye, N.