Bruce Bullen (of Harvard Pilgrim and Massachusetts Medicaid fame) commented on the primary care physician shortage issue (see my earlier post here). First, a word about Bruce. He has a new blog called “Health Reform Musings”, which I’ve provided a link to in the banner to the lower right below. I had an opportunity to work with and for Bruce during the most eventful days of the Harvard Pilgrim turnaround and I can’t think of someone more qualified to provide “musings” on the health care industry and current pressing reform issues. His insight is balanced and informed.
The potential impact on the primary care physician shortage of the new reform law may, per Bruce, “… certainly slow the development of accountable care organizations and other forms of managed care.” This is important because while the reform law directly paves the way for expanding coverage for the uninsured, the road is less clear cut in terms of the economic implications. There are pilot programs envisioned in the law which would call upon networks of providers to form “accountable care organizations” or ACOs to more forcefully and directly manage the health of a defined population and the associated resource requirements. Individual state efforts, including here in Massachusetts, will likely pick up the slack in terms of payment reform, again prompting ACO development.
But… if the primary care shortage results in a shortage of critical gatekeepers and care coordination personnel, then ACOs could be stalled coming out of the gate. This is a trend worth watching.