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Chest. 2017 Apr;151(4):930-935. doi: 10.1016/j.chest.2017.01.006. Epub 2017 Jan 13.

Patient-Centered Specialty Practice: Defining the Role of Specialists in Value-Based Health Care.

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Department of Medicine, Division of Internal Medicine, Thomas Jefferson University, Philadelphia, PA. Electronic address:
Department of Medicine, Division of Internal Medicine, Thomas Jefferson University, Philadelphia, PA.
Department of Medicine, Division of Pulmonary and Critical Care, Thomas Jefferson University, Philadelphia, PA.
Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA.


Health care is at a crossroads and under pressure to add value by improving patient experience and health outcomes and reducing costs to the system. Efforts to improve the care model in primary care, such as the patient-centered medical home, have enjoyed some success. However, primary care accounts for only a small portion of total health-care spending, and there is a need for policies and frameworks to support high-quality, cost-efficient care in specialty practices of the medical neighborhood. The Patient-Centered Specialty Practice (PCSP) model offers ambulatory-based specialty practices one such framework, supported by a formal recognition program through the National Committee for Quality Assurance. The key elements of the PCSP model include processes to support timely access to referral requests, improved communication and coordination with patients and referring clinicians, reduced unnecessary and duplicative testing, and an emphasis on continuous measurement of quality, safety, and performance improvement for a population of patients. Evidence to support the model remains limited, and estimates of net costs and value to practices are not fully understood. The PCSP model holds promise for promoting value-based health care in specialty practices. The continued development of appropriate incentives is required to ensure widespread adoption.


Patient-Centered Specialty Practice; health-care utilization; population health; quality improvement; topics in practice management

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