Independence Blue Cross study in The American Journal of Managed Care finds lower costs for those with chronic illness treated in patient-centered medical homes

Three-year study shows reduced costs and hospital utilization for highest risk patients

Results from a three-year study by Independence Blue Cross (IBC) demonstrating reduced costs and utilization for high-risk patients cared for by patient-centered medical homes appear today in The American Journal of Managed Care. The study involved approximately 700 IBC members — most with multiple chronic illnesses including congestive heart failure, chronic obstructive pulmonary disease, diabetes, and asthma — who experience a disproportionately high number of hospital stays and costly health care services.

In the study from 2009 to 2011, the group of high-risk patients treated in primary care practices that made the commitment to transform into a patient-centered medical home (PCMH) had fewer hospital admissions than the matched control patients not treated in medical homes: 10.8 percent fewer in 2009, 8.6 percent fewer in 2010, and 16.6 percent fewer in 2011. In addition, in 2009 and 2010, there was a savings in total medical costs of 11.2 percent and 7.9 percent, respectively, for the PCMH high-risk group.

"It is gratifying to see that better coordinated primary care, directed at people who are the most ill, works," said Somesh Nigam, IBC's chief informatics officer and a contributor to the study. "The rigorous methodology used to focus on this vulnerable population was critical to show the benefit of medical homes in a dynamic health care environment." 

This is the first in a series of publications authored by IBC Informatics which will show the benefits of PCMH for those with chronic conditions. "These findings demonstrate the favorable impact of the PCMH on improving quality and lowering the cost of care for those patients who are most seriously ill and have the most to gain from better access and coordination of care. This is especially relevant in light of the Affordable Care Act, which includes provisions that support the medical home model," said Richard Snyder, MD and chief medical officer at Independence Blue Cross. "We are proud to support primary care practices that commit to become recognized as medical homes. The primary care physicians who transformed their practices deserve tremendous credit." 

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