Moving Ahead with the PCMH: Some Progress, but More Testing Needed

Abstract

The current plight of the primary care delivery system has been well described. Whether due to low reimbursement rates, low perceived prestige, or a chaotic and uncoordinated style of practice that has evolved under fee-for-service reimbursement, the US primary care system is at a crossroads. Many primary care physicians are approaching retirement age and few graduating medical students are choosing to enter primary care. Current projections show a marked shortfall in the number of primary care physicians needed to provide care, and these projections predate the passage of the Affordable Care Act (ACA), which will bring some 30-plus million persons into the primary care system.1 Simply stated, the financing, organization, and delivery of primary care services must change, or within a relatively short period of time, there will be no functioning primary care system in the US.