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Polakoff to Worcester Business Journal: Team-based primary care crucial to managed care

UMass Medical School experts says a team-based approach to primary care is key to managed care models that have been integrated into primary care, pediatrics and geriatrics, according to an article in the Worcester Business Journal.

“There’s a phrase in medicine, which is, ‘Keep every member of the team working at the top of their license,’ so you don’t have physicians doing what nurses should do, you don’t have nurses doing what educators should do, and you don’t have educators doing what a care coordinator should do,” said David Polakoff, MD, professor of family medicine & community health, chief medical officer and associate dean of UMass Medical School’s Commonwealth Medicine division.

Dr. Polakoff also is co-lead of the Southern New England Practice Transformation Network, an initiative led by UMass Medical School and UConn Health to help clinical practices with transformation efforts through technical assistance and coaching. The initiative is funded by the Centers for Medicare & Medicaid Services.

The article points to the commonly used fee-for-service reimbursement system for physicians as an obstacle to transition to a team-based model.

“More visits don’t necessarily mean patients are healthier,” Polakoff told Worcester Business Journal. “We are trying to transition into a model where practices are paid to keep people healthy.”

Eight of UMass Memorial Health Care’s largest primary care offices have been designated patient-centered medical homes by the National Committee for Quality Assurance, said Daniel Lasser, MD, MPH, chair and professor of family medicine & community health. The designation means the offices use a team-based approach, are available after hours, coordinate care with emergency rooms and do pre-visit planning, Dr. Lasser said in the article, adding that the approach appeals to future primary care physicians considering residencies at UMass Medical School.

“They want to learn in these kinds of settings. The fact that we have done this in a larger teaching practice is good for teaching the next generation of providers [and] makes us attractive to people applying for residency programs or even for medical students,” Lasser told Worcester Business Journal.