Integrating Specialty Care into Primary Care Teams

Aging populations, increasing numbers of insured patients, and a changing reimbursement model based on value rather than traditional fee for service all necessitate innovation in models of health care delivery. In order to meet the needs of patients with high-quality and low-cost treatment, the medical specialists should be integrated into the primary care team to improve continuity across the spectrum of care and to control costs, and thus achieve the Triple Aim for Populations: improving patient care and experience, improving population health, and decreasing costs of health care. Strategies for integrating specialty care into primary care team include increasing care delivery at point of care, developing primary care with special interest, integrated community specialists (ICS). The paper summarizes the experience and achievement of Mayo Clinic in implementing the above three strategies, and argues that the ICS model is viable for those systems where physician compensation is salary based.