In our August 3rd blog we introduced various alternative models of care as a window into potential visions of the future. In this blog, we explore one of those models, the Comprehensive Care Physician (CCP) in greater detail. The CCP model was created by Dr. David Meltzer at the University of Chicago and highlighted in a New York Times article in 2018. The core principle employed was maximizing direct interaction between the patient and their physician. The original model was implemented as a randomized control trial. Two thousand Medicare members with at least one hospitalization in the prior year were enrolled, with estimated annualized costs of $100,000 each. They agreed to be randomly assigned to the CCP practice or to continue with their current provider. The five physicians in the intervention group each had a panel of 200 patients, but because these patients were so high risk, there were sufficient volumes in the hospital to justify rounding every morning and sufficient demand for appointments to keep their afternoon office schedules full. The five doctors rotated afternoon hospital coverage and weekend coverage among themselves and depended on hospitalists for night coverage only. There is also a critically important team component to this model. The practice includes an advanced-practice nurse, registered nurse, social worker and clinic coordinator. Each patient is assigned a team tailored to their needs.. The emphasis is on having the smallest appropriate group to promote continuity and patient engagement. A differentiator of this model is a focus on cross-training rather than practicing at “the top of license.” With maximization of patient engagement as a singular focus, it’s not surprising that physicians are often directly involved in care transitions. They make outbound calls to all patients post-discharge from the hospital, and are notified whenever their patient is in the Emergency Department.