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5 suggestions to advance personalized medicine

 

Among their ideas:

  1. “Before {the patient meets}  with the clinician, a member of the care team  {should} assesses the patient’s level of engagement and capacity for self-management, so that the patient can participate in his or her care in a meaningful way. As part of that process, the patient completes a self-assessment of health needs, preferences, and goals by telephone, electronically, or in person. Through the medical record, this information is conveyed to the clinician before or at the time of the appointment.
  2. “The clinician assesses the patient’s health status and health risks using the best available conventional, genomic, and other precision diagnostic tools. Optimal risk-mitigation and therapeutic goals for the patient are identified.
  3. The clinician and patient set and clearly articulate shared goals, using the clinician’s health assessment and the patient’s self-assessment.
  4. “The shared goals are then incorporated into a personalized health plan that the patient is directly involved in crafting. The clinician chooses appropriate metrics for monitoring progress, identified explicitly for the patient; an electronic medical record is used for data collection and tracking.
  5. “The clinician coordinates care with the rest of the patient’s care team and arranges for appropriate follow-up.

“With this five-step process, the personalized health plan becomes a living, adaptable document — available to all team members — that is continually revisited in person, by phone, and/or via patient portals and mobile applications.”

To read their article, please hit this link.


Will they cut non-primary-care physicians’ fees?

Medical Economics reports that the Medicare Payment Advisory Commission (MedPAC)   will recommend a 1.4 payment cut in 75 percent of non-primary care services in Medicare’s Physician Fee Schedule  in a bid  to continue funding a 10 percent bonus payment for primary-care physicians that expires at the end of 2015.

The American Academy of Family Physicians reported that MedPAC Commissioner Kathy Buto, MPA, said “I’ve been involved with the fee schedule from the start, and there’s never been a year when primary care was funded in a way that was appropriate.” AAFP said that she  suggested valuing primary care separately from specialty care covered by Medicare.

Commissioner William Hall, M.D., questioned whether the bonus payment is enough  to fix the problems with primary care. “If we double the salaries of primary care physicians, we would get more people in primary care, but we would have little or no impact on the system of care that people on Medicare need,” AAFP reported.

Nonprimary-care physicians have good lobbyists in Washington, D.C., too, so it’s hard to predict that their fees will be cut.


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