By Rebecca Adams, CQ HealthBeat Associate Editor
September 6, 2012 -- Medical homes can lower health care costs without jeopardizing the care that patients receive, according to a new compilation of academic and industry-supported projects by a coalition that supports the concept of such patient-centered initiatives.
The 41-page resource guide that was recently discussed at a Capitol Hill briefing lists a series of nearly three dozen experiments around the country and the results that have been reported by the participants. Most of the projects showed a reduction in costs, with many also documenting improvements in the quality of care provided to patients. The report by the Patient-Centered Primary Care Collaborative, an alliance of about 1,000 groups and individuals, described a range of public and private-sector initiatives.
At a time when public and private sector officials are looking for ways to improve coordination, efficiency and cost-effectiveness, the concept of the patient-centered medical home has gained traction and become a buzzword among health policy experts. The Obama administration has supported the development of team-based coordinated care, such as medical homes.
Marci Nielsen, executive director of the Patient-Centered Primary Care Collaborative, noted that 42 state Medicaid programs are testing out coordinated care projects, such as the patient-centered medical home idea.
"No matter what happens in November, transformation of the health delivery system is going to continue," said Carmen Hooker Odom, president of the Milbank Memorial Fund, a health policy foundation that helped pay for the report.
"We are looking to you to embrace this concept" and translate it into public policy, Odom told the audience of mostly Capitol Hill staffers.
Justine Handelman, vice president of legislative and regulatory policy at the BlueCross BlueShield Association, said that the plans affiliated with the association are trying out different types of care delivery models in 47 states and the District of Columbia. She said that the Blues plans represent the nation's largest primary care medical home network, although each plan is tailored to a local market. More than four million of the insurance plans' members are participating in some version of coordinated patient-centered care.
"What we're seeing in the results is tremendous," said Handelman.
For instance, patients in a project sponsored by BlueCross BlueShield of North Dakota had 24 percent fewer emergency visits and 18 percent lower inpatient hospital admission rates than the general population.
"If you can do things in North Dakota, you can do them anywhere," said Handelman.
Other results from medical home-type experiments included:
- In Colorado, well-care visits for kids in Medicare increased from 54 percent of children to 73 percent in 2009.
- In Maryland, CareFirst BlueCross BlueShield saved nearly $40 million in 2011, according to an industry report.
- In North Carolina, a Medicaid community care project saved $60 million in 2003, which grew to $382 million in 2010. There was also a 112 percent increase in flu inoculations.
PCPCC Report (pdf)