Is the new model of family medicine financially viable?

T he Future of Family Medicine project was initiated in 2002 with the goal of transforming and renewing the specialty of family medicine to meet the needs of people and society in a changing environment. The initial project report, based on the work of five different task forces, was published in March 2004 and included 10 specific recommendations “intended to provide a framework to guide a period of active experimentation and innovation within the discipline.” The first of these recommendations is that “family medicine will redesign the work and workplaces of family physicians,” fostering a New Model of family medicine. (The article on page 59 describes the New Model.) The initial report also recommended the creation of an additional task force with two specific goals: 1) to develop a financial model that assesses the impact of the New Model on practice finances, and 2) to recommend health care financial policies that, if implemented, would promote the New Model and the primary medical care function in the United States over the next few decades. This group, Task Force Six, engaged the Lewin Group as consultants to assist with developing the microeconomic (practice-level) and macroeconomic (societal level) financial models necessary to achieve its goals. The consultants conducted two types of analyses. First, they simulated the impact of the New Model on a family medicine practice within the current fee-for-service reimbursement environment. Second, they analyzed alternative reimbursement mechanisms for the New Model to estimate their impact on family physicians’ practices. Task Force Six published its full report in November 2004. This article describes the key findings.