Business Week takes a look at the medical home model, and finds that, lo and behold,  primary care docs can provide high quality coordinated care and boost their income to boot.

Improving patient centered primary care—which means care coordination, prevention, wellness and management of chronic conditions—is a key theme of national health reform, supported across ideological lines. A medical home can take various forms. It can be a large group practice or a solo one like Dr. Peter B. Anderson's in Newport News, Virginia, profiled by Catherine Arnst in the Business Week story. (Or this doctor profiled last year in the Washington Post, a slightly different model). As Cathy writes:

The "home" is the office of a primary-care doctor where patients would go for most of their medical needs. The general practitioner would oversee everything from flu shots to chronic disease management to weight loss, and coordinate care with nurses, pharmacists, and specialists. A 2004 study estimated that if every patient had such a home, the resulting efficiencies might reduce U.S. health-care costs by 5.6%, a savings of $67 billion a year.

She described how Anderson and his team of four nurses (three fulltime and one parttime) take plenty of time to counsel patients about things like weight control, nutrition and smoking. People with chronic conditions get frequent checkups to keep their illnesses under control. And because of the way the doctor and nurses divide and coordinate care, and their successful incorporation of electronic medical records, they see more patients a day than doctors typically do. Abderson's practice sees 30 to 35 patients a day, compared with 20 to 25 for a more typical primary care doctor.

There's a lot of support in Washington for paying primary care doctors more, and shifting the incentives in the system to improve care coordination and prevention.  Anderson, 56, has actually made the medical home model work for him and his patients even in the current system, where the incentives are for more specialty care and procedures, and the results are often fragmentation and overutilization.

 Before he switched to the medical home model five years ago, he worked 50 to 60 hours a week and wasn't able to pay his bills. Now, he's working fewer hours, seeing more patients, making more money and "delivering the best care I've ever done."