The problem with Integrated Health Home Care (IHH) models as used by Magellan of Arizona – a Regional Behavioral Health Authority (RBHA) and the People of Color network (POCN) is the fact that they rely primarily on nurse practitioners to run their IHH clinics.
Such is the case at the Capitol Center at 1540 w Van Buren, in Phoenix, Arizona. Where a single nurse practitioner is in charge of all aspects of patient care for well over 200 patients (out of 600) who signed on to the IHH at the Capitol Center.
The primary concern with this particular IHH model is that nurse practitioners are not doctors.
Many doctors I talked to confidentially about this issue said that they provided “higher-quality care than their nursing counterparts and that increasing the number of nurse practitioners in primary care would not necessarily improve safety, effectiveness, equity or quality.”
Some doctors went so far as to state that nurse practitioners would have a detrimental effect on the safety and effectiveness of care…
The reason why Magellan and the People of Color network uses nurse practitioners instead of doctors at its IHH clinics is the fact that they are much cheaper than qualified doctors, as such they are paid substantially less for doing essentially the same work. With that being said the qualifications between the two are enormous.
“These are not just professional differences,” said Karen Donelan, the lead author of the study and a senior scientist at the Mongan Institute for Health Policy at Massachusetts General Hospital in Boston. “This is an interplanetary gulf,” she said, echoing a point in an op-ed recently published online (source: http://www.nejm.org/doi/full/10.1056/NEJMe1303343).
Simply put nurse practitioners do not have near the depth or length of education that physicians do. Pretending otherwise is a huge mistake, especially for patients – who would be well advised to see a qualified doctor for their primary care rather than settle for a nurse practitioner.
I contacted Magellan of Arizona for comment on this story and officials ignored our emails and telephone calls.