AHA plans for redesigned primary care model

Share this article: With less than a year remaining before the Affordable Care Act (ACA) expands insurance coverage to 30 million Americans, the American Hospital Association (AHA) is examining how workforce and care delivery models will change. The AHA published a white paper that includes recommendations that came out of a group of nine physicians and nurse leaders who were tasked with discussing how hospitals and healthcare systems should plan workforce strategies to meet demands for primary care services. The group’s suggested changes to the primary care workforce highlight the need to establish interdisciplinary care teams that focus on treating the overall health of patients, not just specific episodes of care. “The workforce must change how it functions on multiple levels. Care must be provided by inter-professional teams where work is role-based, not task-based, and the team must be empowered to create effective approaches for delivering care,” the authors wrote. The AHA actually developed an Accountability-Based Primary Care Workforce Model, which details the responsibilities for each of the care team members. For example, the physician diagnoses and oversees the plan of care, while the registered nurse triages patients, provides education, and manages the patient’s overall care. The clinical social worker provides case management and supports community linkages for patients and families. The nutritionist oversees and manages dietary-related issues for patients. These changes to the primary care workforce come with challenges. First of all, clinical education curricula must be redesigned to prepare providers to function in a team-based environment. Perhaps more importantly, current clinicians must be retrained to work in a multidisciplinary team. Another barrier to the team approach is the fact that some states restrict certain providers’ scope of practice, thus limiting their contribution to the team. As the healthcare industry learns lessons from demonstration projects such as the Comprehensive Primary Care Initiative and The Federally Qualified Health Center (FQHC) Advanced Primary Care Practice, the educational and regulatory environment will likely become more favorable for team-based, patient-centered care. In the meantime, locum tenens physicians and nurse practitioners should be proactive and seek training in team-based care in order to become more desirable candidates in the changing primary care workforce.

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