Group Health Cooperative PCMH Program

Program Location: 
Seattle, WA
Payer Type: 
Commercial
Partner Organizations: 
Group Health Research Institute
Payers: 
Group Health Cooperative

Reported Outcomes

Description: 

Group Health Cooperative is an integrated health plan and health care system that has been a leader in developing the medical home. Group Health has integrated into their primary care enhanced technology that has improved patient access and information sharing across a multi-disciplinary care team, dedicated care coordination services, preventive care and screening, and chronic condition management. During their initial medical home pilot, each primary care doctor claimed responsibility for a total of 1,800 patients as opposed to 2,300. The reduction in the number of patients allowed physicians time to coordinate care, have daily “team huddles” and allow for extended 30-minute office visits per patient. The reduction in patient-to-physician ratio also created a need to invest in extra staffing. As a result the study found that the medical home was investing $16 more per patient over the following year. This meant the need for 72 percent more clinical pharmacists, 44 percent more physician assistants, 18 percent more medical assistants, 17 percent more registered nurses, and 15 percent more primary doctors. Evaluation of the model showed that costs were recouped within the year, primarily through emergency room savings.

 

Fewer ED / Hospital Visits: 

Annals of Family Medicine (May 2013)

  • Declines in ED visits in early and late stabilization phases relative to secular trends in network practices (13.7% v. 18.5%)
Improved Patient/Clinician Satisfaction: 

Health Affairs (May 2010)

  • The quality of care was higher, patients reported having better experiences, and clinicians said they felt less “burned out.”

American Journal of Managed Care (September 2009)

  • "For staff burnout, 10% of PCMH staff reported high emotional exhaustion at 12 months compared with 30% of controls, despite similar rates at baseline."
Improved Access: 

Annals of Family Medicine (May 2013)

  • 123% increase in secure message threads
  • 20% increase in telephone encounters
  • 4.5% fewer face-to-face visits
Cost Savings: 

Health Affairs (May 2010)

  • For every dollar Group Health invested, mostly to boost staffing, it recouped $1.50
  • Patients had 29 percent fewer emergency visits and 6 percent fewer hospitalizations, resulting in a net savings of $10 per patient per month.
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