In a recent blog post, Rachael Addicott, Senior Research Fellow for the King’s Fund, an independent charity working to improve health and health care in England, reviewed a survey of primary care providers performed by the Commonwealth Fund and the Kaiser Family Foundation in the first quarter of 2015.

According to the survey, Slightly more than half of primary care physicians reported receiving financial incentives based on the quality or efficiency of care, although one-third of physicians continue to be paid exclusively on a fee-for-service basis. Three of 10 primary care physicians said their practice is qualified as a patient-centered medical home (PCMH) or advanced primary care practice. A similar share is currently participating in accountable care organizations (ACO). Nurse practitioners and physician assistants reported lower levels of participation in ACOs than did physicians, and many were unsure whether their practice participates in one or not.

Addicott observes: Impact takes time. We know from previous work on contracting for integrated care that providers need time to learn how to work together and to build the necessary infrastructure and capacity. New structures or contracts will not fast-track these relationships.

She cautions that the NHS might do well to wait to see how ACO’s work out here before attempting them in England.

I’m going to beat my favorite drum and say that for those of us who don’t have the luxury of waiting to see how all this change works out, figuring out how to SUPPORT providers in their efforts to do this learning and build the necessary relationships is a strategic move which will separate successful implementations from those which struggle. This isn’t a task for which we can construct formal training – and the appetite among providers who are feeling new pressures on their bottom line is for sitting through canned training presentations isn’t likely to be very high anyway. But providing them an online platform on which they can connect with and learn from one another, informally, could do a lot to spread best practices and build the relationships which will be the engine of successful change.