We examined quality, satisfaction, financial, and productivity outcomes associated with implementation of Care by Design (CBD), the University of Utah's version of the patient-centered medical home.
Since 2010, the number of PCMH providers in NYS has increased from 633 to 4,461. As of mid-2012, over 1.4 million Medicaid managed care (MMC) and CHPlus enrollees are assigned to PCMH providers. In 2011, about 75,000 Medicaid fee-for-service (FFS) members had a visit with a PCMH provider. For the first six months of 2012, this number increased to 84,000. As this number represents unique recipients and not visits, there is no expectation that the number for the full year will double or increase substantially.
CONTEXT: Patient-centered medical homes (PCMHs) are intended to actively provide effective care by physician-led teams, where patients take a leading role and responsibility.
OBJECTIVE: To determine whether the Walter Reed PCMH has reduced costs while at least maintaining if not improving access to and quality of care, and to determine whether access, quality, and cost impacts differ by chronic condition status.
High-Intensity Primary Care Payment: Good Return on Investment for Employers
As the largest purchaser of health care in America, employers are paying a high price for care of variable quality. To check soaring costs, some employers are switching from the inefficient fee-for-service model of paying for care, which encourages high volume and low quality, to payment models that reward high value.
Based on the success of its one-year pilot program, Highmark Inc. announced today that it is expanding its patient-centered medical home (PCMH) initiative to include nearly 1,050 primary care doctors in more than 100 physician practices that cover about 171,000 Highmark members in western and central Pennsylvania and West Virginia. The original program, initiated in 2011, included 160 primary care doctors in 12 practices that cover about 45,000 members.
Value-Based Insurance Design (V-BID) - hailed as a "game changer" by the National Coalition on Health Care - refers to insurance designs that cary consumer cost-sharing to distinguish between high-value and low-value health care services and providers. V-BID entails (1) reducing financial barriers that deter use of evidence-based services and high-performing providers, and (2) imposing disincentives to discourage use of low-value care.
A study published in the November issue of the leading policy journal Health Affairs shows that Cigna's (NYSE: CI) collaborative accountable care (CAC) model has favorable quality of care and total medical cost trends. The study reports interim quality and cost results among three geographically and structurally diverse physician practices in Arizona, New Hampshire and Texas.
