After three years, CareFirst’s large-scale, region-wide Patient-Centered Medical Home Program (PCMH) is continuing to lower the rising costs of care for CareFirst members covered by the program. In addition, emerging data suggests that CareFirst members under the care of participating PCMH physicians fare well when measured on key quality indicators. These trends are encouraging as CareFirst’s PCMH Program now matures and is well into its fourth year of operation.
The report lays out how Oregon's coordinated care organizations (CCO) performed on quality measures in 2013. This is the fourth such report since coordinated care organizations were launched in 2012 and the first to show a full year of data. This report also shows the quality measures broken out by race and ethnicity.
Proving that patients benefit when physicians and health plans share resources and work together, Aetna (NYSE: AET) and the WESTMED Medical Group today announced results of the first year of their patient-centered medical home program. Based on the excellent results, the Aetna – WESTMED relationship will be expanded to include a Medicare Collaborative Care Agreement as well.
OBJECTIVE: To determine the impact of Florida's Medicaid Demonstration 4 years post-implementation on per member per month (PMPM) Medicaid expenditures and whether receiving care through HMOs versus provider service networks (PSNs) in the Demonstration was associated with PMPM expenditures.
DATA: Florida Medicaid claims from two fiscal years prior to implementation of the Demonstration (FY0405, FY0506) and the first four fiscal years after implementation (FY0607-FY0910) from two urban Demonstration counties and two urban non-Demonstration counties.
The Accountable Care Organization (ACO) formed by Anthem Blue Cross (Anthem) and HealthCare Partners in California produced $4.7 million in savings for the first six months of 2013 compared to a comparison group, Anthem and HealthCare Partners announced today.
In contrast to some physicians, John Toussaint, MD, and his colleagues in northeast Wisconsin don’t mind when the quality of care they provide is measured or even when they are compared to their peers. More than most, Toussaint, previously an internist who now works full-time as CEO of ThedaCare Health System’s Center for Healthcare Value in Appleton, Wis., embraces transparency, and even welcomes having his pay tied to performance, something studies and doctor surveys show remain a worry or even a foreign concept to most physicians across the country.
The patient-centered medical home (PCMH) has been advanced as a promising framework for transforming primary care. In 2007, the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association issued the “Joint Principles of the Patient-Centered Medical Home,” which outlined the PCMH model. The medical home model emphasizes a team-based approach to primary care, in which a physician-leader coordinates care by other providers across multiple sites and specialties.
The Affordable Care Act provides states with a significant opportunity to support care coordination and care management for individuals with complex health needs through health homes. Given tight state budgets, states implementing health homes benefit from enhanced federal support for a limited time period, enabling delivery system investment and innovation that might not otherwise be within reach. Due to the time-limited nature of enhanced federal health home funding, states that implement these new models must do so with an eye toward sustainability and return on investment.
Looking for ways to improve the health of beneficiaries and address the escalating costs of care, the self-insured Fresno Unified School District/Joint Health Management Board (JHMB) decided in late 2010 to join the California Academy of Family Physicians (CAFP) in supporting a local Patient Centered Medical Home (PCMH) initiative. In July 2012, after 18 months of preparation and training, a primary care medical group – Community Medical Providers (CMP) – launched the initiative. One year later, at the end of June 2013, CMP had saved the district nearly $1 million in total claims.
