A Systems View of the Changing Healthcare Landscape and Health Education's Contributions

The current fee-for-service payment system in health care makes it difficult for implementation of the patient-centered medical home (PCMH) model. Some services such as patient education and telephone contacts are not reimbursable, while others are inadequately reimbursed and discourage medical providers from engaging in PCMH (e.g. working with patients to develop care plans). Public and private insurers are reluctant to pay more for medical home services without assurances that patients will have improved outcomes and that costs will be reduced. This presentation will review some of the broader systems changes being considered that will impact hospitals and public health agencies at the state/local level. The role, challenges and opportunities of health educators in facilitating these systems changes from a volume-driven health care system to a value-driven health care system will be discussed.