A health care system that is affordable and appears to offer high-quality care may not do much good if patients cannot actually get in to see the doctors.

Karen Davis, president of the Commonwealth Fund, New York, makes that case in a report on accountable care organizations (ACO) and patient-centered medical homes put out by Health2 Resources, Washington.

Health2 Resources brought together experts from many employer, health care and health insurance organizations, including UnitedHealth Group Inc., Minnetonka, Minn. (NYSE:UNH), and Humana Inc., Louisville, Ky. (NYSE:HUM), and they had a hard time coming up with concrete, specific proposals for how to promote ACO efforts and similar efforts. They mostly agreed that compensation programs ought to be different and than patients should somehow be involved in developing the new system.

Davis, who represents a health policy research group, came up with more concrete suggestions based on her own experience with sitting in an emergency room simply because her own doctor was available.

Davis suggested that health care organizations that want to be genuinely accountable and genuinely patient-centered ought to make urgent care providers available in the evening and on weekends, rather than forcing patients who need immediate care for conditions that are not life-threatening emergencies to go to emergency rooms, according to a Health2 Resources account of the “national thought leaders’” efforts.

Similarly, primary care physicians ought to provide same-day or next-day access, and patients should have a reasonable chance of getting in to see their own personal primary care providers, Davis said.

To make the U.S. health care system work for patients, policymakers must “actively support federal funding of primary care workforce training efforts across the full spectrum of primary care team members in order to ensure an adequate and well-trained primary care workforce,” Davis said.

Policymakers also ensure that policies and initiatives that promote ACOs and patient-centered medical homes ensure superb patient access to care, including off-hours care, same-day or next-day care, and telephone and electronic consultations, Davis said.

- Allison Bell

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