Primary care gets boost from stimulus money, experiment on 'medical home'

Jul 30 2009

"Secretary of Health and Human Services Kathleen Sebelius announced Tuesday that $200 million will be available for grants, loans, loan repayments and scholarships for the training of some 8,000 health professionals by the end of fiscal 2010," Congressional Quarterly reports. 

The money will 'provide targeted investments in primary care, nursing, faculty development, and equipment purchases that will shore up the workforce as we prepare for reform,' HHS Secretary Kathleen Sebelius said" (7/28).

Meanwhile, CBS News reports on "a national experiment called Medical Home, which increases the pay and power of family doctors." Dr. Joseph Mambu, a primary care physician, is part of the experiment. "On average specialists make twice as much as primary physicians. A starting cardiologist, with three to five years more training makes up to $350,000 a year. A starting family doctor makes $149,000, mostly because they aren't paid for the extra time spent counseling patients." But now Mambu's practice "gets a 10 per cent bonus, and has hired extra nurses who stay in close touch with patients, handling the details of care. It frees him up to spend more time with each patient, better manage chronic diseases like diabetes, and avoid any extra trips to specialists."

"But as the system begins to pay primary care doctors more, the pressure is on to pay specialists less. Medicare just proposed a pay cut of up 40 per cent for specialists, like radiologists and cardiologists, and pay increases of up to 8 percent for family doctors. Specialists complain the cuts will reduce their service in rural areas, and still not raise enough money to recruit more family physicians" (Andrews, 7/28).