Patient-centered medical homes improve care and patient experience, study finds
(Grand Rapids, Mich. - December 13, 2011)
These are among the findings of the Priority Health Patient-Centered Medical home (PCMH) pilot initiative. The three-year study concluded earlier this year.
“This medical home initiative was the latest in our 15-year history of supporting primary care,” said Chief Medical Officer Jim Byrne, M.D. “By optimizing members’ health and ensuring they have the best care experiences, we can eliminate avoidable costs like unnecessary emergency room visits.”
Summary
Results from the medical home pilot practices are favorable on several measures including:
Improved prevention and diabetes care. Priority Health PCMH transformation work resulted in rates of optimal diabetes care 4.5 percentage points higher at participating practices than in our control group.
A trend towards lower ED utilization by members with diabetes. Over the course of the pilot, use of the ED among diabetes patients decreased relative to rates at comparable practices – an estimated impact of 52.1 visits per 1000 members.
Improved patient experience. When evaluating patient experience, the pilot practices had overall statistically significant improvements. The results showed an improvement in patient experience and quality of care while keeping health care costs flat.
The pilot gave 16 practices in the Priority Health network an opportunity to adopt primary care innovations they didn’t otherwise have the resources to enact.
Background
The PCMH pilot arose from Priority Health’s desire to expand its longstanding support of primary care. This included providing grants to support infrastructure development; technical assistance; and best practices conferences to foster learning.
The lessons learned from this pilot led to enhanced reimbursement for primary care services that promote access, care coordination and patient engagement.
- In 2009, Priority Health put in place a series of payment reforms to encourage providers to improve access to their services. These included payments for PCMH recognition, telephonic, group and e-visits.
- In 2011, Priority Health continued PCMH recognition and further expanded payment to include infrastructure payments around care coordination and health information technology.
- For 2012, the commitment remains for infrastructure payment enhancement to support all primary care practices that are committed to PCMH.
All of these payments were opened to the entire network (not limited to practices involved in the medical home pilot).
About Priority Health:
Priority Health is an award-winning health plan nationally recognized for creating innovative solutions that impact health care costs while maximizing customer experience. It offers a broad portfolio of products for employer groups and individuals including Medicare and Medicaid beneficiaries. As a nonprofit company, Priority Health serves more than 600,000 people and continues to be rated among the best health plans in the nation by the National Committee for Quality Assurance.
