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How Teamwork Can Save Primary Care

Alexandra Wilson Pecci, for HealthLeaders Media, August 27, 2013

"It's not an either/ or," Bazemore says of who's providing primary care. "If we can collectively work for educational and payment policy changes… you're likely to see more movement into primary care and far less concern with who fills singular patient roles."

In fact, many providers are already adopting this team-based approach to care. Bazemore points to a Journal of the American Board of Family Medicine policy brief which shows that nearly 60% of family physicians "reported routinely working with NPs, PAs, or CNMs [certified nurse midwives]. Physicians more likely to work with these clinicians were younger and live in rural areas."

"There is likely a broader opportunity for them to be working together in teams," Bazemore says. "That requires a shift in the way we pay for primary care."

Phillips agrees.

"The old scope of practice battles are not only tired, they're dangerous at this point," he says, adding that since primary care needs to get more complex and more comprehensive, the healthcare system needs all providers to work together. "The shortage is just too big."


Alexandra Wilson Pecci is a managing editor for HealthLeaders Media.

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2 comments on "How Teamwork Can Save Primary Care"


Dave Mttman, PA, DFAAPA (8/28/2013 at 10:12 AM)
That it's not that easy is right. Nps and PAs are kept away from primary care by barriers that make it harder to practice than many other specialties. Put a call into the Association of Family Practice PAs and the AANP please. Get both sides of the picture. You only quote the AAFP who let me say as a PA has been rabidly against PAs and NPs doing anything more than what we are doing now. When teams really function as teams we will be on them. The AAFP does not want a team-just it running the show. Please have your commentary reflect that fact also. Dave Mittman, PA, DFAAPA

Peter McMenamin, PhD (8/27/2013 at 3:24 PM)
There are other ways of estimating primary care performance of NPs. CMS recently awarded nearly $50 million to 35,080 NPs billing Medicare Part B carriers under their own NPIs for exceptional provision of primary care services. That was more than two thirds of the NPs enrolled as Part B providers. This is explained in more detail in http://www.ananursespace.org/BlogsMain/BlogViewer/?BlogKey=ee0e605b-0499-4b47-bfe4-941fb9e13715. CMS data also reveal that of all NPs participating in Part B, only 15% indicated a non-primary care NP taxonomy when first registered for their NPI. Were Medicare to operate with a national scope of practice for APRNs like the VA or DOD, Medicare beneficiaries would have even greater access to primary care services. This is needed because between 2 to 3 million persons will age into Medicare every year for the rest of the century.