{"title":"The schizophrenia of physician extender utilization.","authors":"Thomas R McLean","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>The Patient Protection and Affordable Care Act of 2010 provides incentives for healthcare to be delivered by Affordable Care Organizations (ACOs). The public face of many, if not most, ACOs is likely to be the Patient Centered Medical Home (PCMHs), a business structure that evolved from Retail Medical Clinics, which made greater use of physician extenders (PAs). Accordingly, this paper examines the evolution and structure of PCMHs as well as how the PCMH is regulated. As neither legal or market regulatory mechanisms are ideal for policing business structures that employ PAs, this paper concludes that the tort reform most appropriate for PCMHs is the introduction of either no-fault or enterprise liability coverage.</p>","PeriodicalId":79788,"journal":{"name":"Annals of health law","volume":"20 2","pages":"205-51, 5-6p preceding i"},"PeriodicalIF":0.0000,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of health law","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
The Patient Protection and Affordable Care Act of 2010 provides incentives for healthcare to be delivered by Affordable Care Organizations (ACOs). The public face of many, if not most, ACOs is likely to be the Patient Centered Medical Home (PCMHs), a business structure that evolved from Retail Medical Clinics, which made greater use of physician extenders (PAs). Accordingly, this paper examines the evolution and structure of PCMHs as well as how the PCMH is regulated. As neither legal or market regulatory mechanisms are ideal for policing business structures that employ PAs, this paper concludes that the tort reform most appropriate for PCMHs is the introduction of either no-fault or enterprise liability coverage.
2010年的《患者保护和平价医疗法案》(Patient Protection and Affordable Care Act of 2010)为平价医疗组织(ACOs)提供的医疗服务提供了激励。许多(如果不是大多数的话)aco的公众形象很可能是以患者为中心的医疗之家(PCMHs)，这是一种从零售医疗诊所演变而来的业务结构，后者更多地利用了医师扩展者(pa)。在此基础上，本文探讨了医疗卫生服务的演变、结构以及医疗卫生服务是如何受到监管的。由于法律或市场监管机制都不适合监管采用私人照护的业务结构，因此本文得出结论，对于私人照护机构而言，最适合的侵权改革是引入无过错或企业责任保险。
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