CHCS - Center for Health Care Strategies

Improving the quality and cost-effectiveness of publicly financed health care

Creating Physician-Support Entities in Medicaid

Type:
Policy & Issue Briefs
Author:
Nikki Highsmith, CHCS
Published:
June 2011
Funder:
The Commonwealth Fund

With Medicaid poised to absorb 16 to 20 million additional beneficiaries in 2014 as a result of the Affordable Care Act, the imperative to improve primary care capacity for Medicaid populations has never been stronger.  To truly transform care delivery, physician practices need supports, and networks of physicians that join together can potentially share resources among practices to enhance their efficiency.

Physician-support entities (PSEs) offer an emerging opportunity to enhance the capabilities of evolving physician networks. PSEs can be based on physician, health plan or community organizations that form to provide quality improvement, performance measurement, health information technology, care management, and leadership support to practices. PSEs can also be building blocks to help establish more organized Accountable Care Organizations.

Based on a meeting with national experts in fall 2010 supported by The Commonwealth Fund, this brief outlines eight strategies for Medicaid agencies to catalyze the successful creation of PSEs.

 

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