Maryland Family Physicians Lead Health Care Efforts, Innovations — AAFP News Now — AAFP

Khanna is convinced that family physicians are best suited for the leadership role in the state innovation model because of their background and training. "We come in with the whole person orientation, the psychosocial model and a deep understanding of the patient as a partner in their health care," says Khanna. "Family physicians traditionally have been the go-to doctor, and (the) PCMH allows us to provide patient-centered care."

Family physician Donald Shell, M.D., M.A., director of the Cancer and Chronic Disease Bureau and interim director for the Center for Chronic Disease Prevention and Control at the Maryland Department of Health and Mental Hygiene, agrees with that assessment, saying that "family medicine really gives you a broad swath of medicine and health care," which makes family physicians natural leaders in the health care field.

In partnership with the Maryland Million Hearts program(dhmh.maryland.gov), Shell works with Khanna to educate PCMH practices about state resources that are available to help patients achieve better health outcomes in cardiovascular and other chronic diseases. "I recently spoke to some PCMH practices about tobacco-related initiatives and making sure the physicians in the PCMH practices are aware of tobacco cessation resources," says Shell.

The work of Shell, Khanna and other family physicians in helping practices achieve PCMH recognition and better health outcomes for their patients has earned attention beyond the borders of Maryland, too. For example, CMS awarded multiple Maryland applicants accountable care organization (ACO) status as part of the Medicare Shared Savings Program. To quality for ACO status, entities are required to demonstrate a strong foundation of primary care physicians who are able to improve health outcomes and achieve savings, notes Czapp.

Family physicians in the state also have encouraged adoption of electronic health records and have played key roles in connecting primary care practices with the state’s health information exchange. "We have many primary care practices that are well down the road of the patient-centered medical home and achieving meaningful use with electronic medical records," says Czapp, who chairs the board of one of the state’s ACOs. "Those are the qualifications that allow us to say to CMS, ‘We are confident enough in our ability to sign up for this program and demonstrate some savings that we can share among our doctors.’"

Looking to the Future Czapp and other family physicians in the state are quick to acknowledge that Maryland is a progressive state in terms of health care delivery and innovation. That factor has allowed family physicians in the state to "step up," according to Czapp.

She says she is "shocked" that some states are struggling to initiate PCMH initiatives because officials in those states consider the PCMH experimental. "Light bulbs are experimental," she jokes.

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