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Health Care Reform Unfinished, Part 2: The Family Doctor: A Practice Model On Life Support?

(credit: MANDEL NGAN/AFP/Getty Images)

(credit: MANDEL NGAN/AFP/Getty Images)

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This week, KYW Newsradio is presenting a special report, “Health Care Reform – Unfinished.” To read Part 1, click here.

By Pat Loeb

PHILADELPHIA (CBS) – The Obama administration says it met its goal of enrolling seven-Million Americans in health insurance under the Affordable Care Act. But even if it proves to be accurate, it alone does not equal success for the Act. One of the Act’s goals that is falling short is support for primary care doctors.

To thousands of patients in the Landsdale area, Dr. Barry Green is the face of the health care system. He’s in an independent family practice, the kind that grew fragile as insurance and government payments rewarded procedure-heavy specialties — and that ObamaCare was supposed to shore up with a variety of incentives.

“I haven’t seen that happen. I haven’t seen that effect.”

Dr. Green says primary care practices are still struggling, “I don’t see how practices survive today. The economics are challenging.”

Government payment incentives are tied to quality measures, which doctors agree are good but that raise administrative costs, and many private insurers don’t reward those extra investments.

An exception is Independence Blue Cross. “We knew we needed to pay physicians more,” says Dr. Rich Snyder, chief medical officer at IBC.

He says Blue Cross has raised base pay and doubled incentives for primary care doctors who meet quality measures and he says they’re already reporting higher satisfaction.

“They’re very, very happy that we’re enabling that for them.”

Dr. Green is one of those but he sees a challenge on the horizon: “Recruiting the best and brightest residents into primary care.”

He says the higher reimbursements don’t offset the debt medical students incur. Payments still favor specialties, though he believes the value is in primary care.

“I value our specialists, but I’d just as soon my patient didn’t have a bypass.”

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