The Accountable Physician Practice
An Accountable Physician Practice is a multispecialty medical group or physician organization that strives to integrate and coordinate the work of a community of physicians and health care professionals to provide comprehensive outpatient services for patients. These health care professionals work in teams and are supported by the organization’s work flow processes, communications procedures, and payment systems to easily get patients the care they need when they need it.

The Accountable Physician Practice is more than a “medical home.” The Accountable Physician Practice is an advanced medical “village,” bringing together a full community of health care professionals and the supporting infrastructure to help a primary care doctor take care of patients.

Accountable Physician Practices are at the forefront of bringing about the Institute of Medicine's vision of an ideal health care system, one that is safe, effective, patient-centered, timely, efficient, and equitable. Group practices are currently using many elements of that ideal delivery system, and are discovering how beneficial an accountable, coordinated system is to the quality of the care they delver and to the way they practice medicine.

The Accountable Physician Practice model is a valuable alternative to solo-practice medicine. It is a model with a rich history of proven results. These group-practice systems have made a multitude of contributions to American health care in areas as varied as chronic disease management, technology implementation, quality improvement, clinical research, and national health policy.

These multispecialty medical groups can provide greater accountability for the quality and cost of care because they have the organizational structure, resources, and information base to do so.

“Such groups are more than collections of doctors loosely related to each other through independent practice associations. Rather, they are entities with a psychological sense of belonging and identification with the group fostered by a common vision, a shared culture, and accountable leadership.”
From “Prepaid Groups and Organized Delivery Systems: Promise, Performance, and Potential,” by Stephen M. Shortell and Julie Schmittdiel, published in Alain Enthoven’s Towards a 21st Century Health System, 2004.

“CAPP’s 35 MSMGs [multispecialty medical groups] share a common vision as learning organizations dedicated to the improvement of clinical care. Their features include physician leadership and governance; commitment to evidence-based care management processes; well-developed quality improvement systems; team-based care; the use of advance clinical information technology; and the collection, analysis, and distribution of clinical performance information. These features are congruent with the [Institute of Medicine’s] recommendations on key elements needed to redesign delivery systems.”

From Chapter 5, “Developing the Test Bed—Linking Integrated Service Delivery Systems: Council of Accountable Physician Practices,” by Michael A. Mustile, MD. The Learning Healthcare System: Workshop Summary (IOM Roundtable on Evidence-Based Medicine), edited by LeighAnne Olsen, Dara Aisner, and J. Michael McGinnis, National Academies Press, 2007.

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“A shift from the current care model to a more coordinated care model centered on primary care is one potential way to help stave off the healthcare dilemma.”

“It's too expensive to be a primary-care doctor,” by Debra A. Geihsler, president and CEO of Harvard Vanguard Medical Associates & Atrius Health. Boston Globe, July 25, 2007.

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Medicare Payment Advisory Committee’s March 2007 Report to the Congress: “In three of the four [metropolitan statistical] areas, beneficiaries whose main physician was in multispecialty or hospital-affiliated groups had lower average annual spending than beneficiaries whose main physician was in solo or single-specialty groups. At the highest quintile of spending, all four areas show lower average spending for beneficiaries whose main physicians were in multispecialty or hospital-affiliated groups.”

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