Reimagining Primary Care

November 14, 2013 § Leave a comment

Beginning on October 1st, Commonwealth Care Alliance began administering the One Care plan, a three-year state demonstration program funded by the Centers for Medicare and Medicaid Services (CMS) for people who are dual eligible. It’s based on a model of enhanced primary care and support services that Commonwealth Care Alliance has been practicing for many years.

Reporter Meghna Chakrabarti, host of WBUR’s Radio Boston, recently sat down with our CEO Dr. Robert Master to talk about One Care and his hopes for the program. During their interview, Master talked about his vision for transforming primary care.

Read an excerpt of the transcribed interview below or listen to the full audio.

Chakrabarti: Let’s put this in really concrete terms. Let’s create a fictional patient here. For example, someone who is grossly obese and has all the concurrent problems that come along with that, maybe kidney problems, diabetes, incipient blindness. Perhaps it’s indeed due in part to medications or certain mental illness and maybe unstable home environment. Perhaps a past history of drug or alcohol abuse. All these things happen at once. So here’s our fictional patient.

Master: What is needed is – instead of a primary care physician that is cut off from the needs of this individual working in a typical practice – an interdisciplinary team. It would be a doctor, it would be nurse, nurse practitioner, behavioral health or mental health professional clinicians, nonprofessional peer supports. Those are elements of the team.

Primary care is not a place. It’s not a building, and it’s not an appointment. The re-imagined approach is that we will put physicians, nurses, nurse practitioners, outreach workers, community health workers and peer support and psychiatry together in a system of cure that will reach into the world where people live –whether it’s in their home, whether it’s in a supportive housing environment, whether it’s under the bridge or in a shelter. That’s where you have to bring that, and when we do that, all of those investments in the system are more than offset by reduced recurrent hospitalizations that occur because of the failure of our inability to do these.

To listen to the full interview, visit Radio Boston’s website at


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