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How independent primary care clinicians leverage trust to help vulnerable populations
How independent primary care clinicians leverage trust to help vulnerable populations
KEY FEATURE. Two independent primary care clinics, one in Vermont and one in New Hampshire, have leveraged their independence to tailor services to patients who struggle to afford care, have chronic physical or behavioral health conditions, and/or need help finding social supports. TARGET POPULATION. The practices serve a wide swath of patients, including many people covered by Medicaid and others with bare-bones private plans. WHY IT'S IMPORTANT. Independent primary care clinicians are often absent from debates about how to reform U.S. health care. Independent primary care clinicians, particularly nurse practitioners, often fill care gaps in underserved communities, which have been hard hit by the coronavirus. BENEFITS. Both clinics have achieved high levels of performance on measures of preventive services and chronic disease management. They have earned some additional revenue through value-based or capitated contracts. CHALLENGES. The practices struggle to sustain their small businesses while dealing with disparate and evolving payment arrangements. They've also had difficulty finding psychiatrists for their patients. To cope, the Vermont clinic hired a part-time psychiatric nurse practitioner.
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