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PCMH model a success to be reckoned with according to PCPCC report


A new health report released by the Patient-Centered Primary Care Collaborative (PCPCC) documents the adoption of the patient-centered medical home model (PCMH) in the U.S. as nothing short of impressive.

[See also: Aetna launches PCMH program in Connecticut and New Jersey]

"The number of medical home providers has grown to the tens of thousands, serving millions of Americans," reads the Benefits of Implementing the Primary Care Patient-Centered Medical Home: A Review of Cost and Quality Results, 2012 "Momentum for the model is rapidly increasing with public and private sector investment.”

Complementary to the PCPCC’s 2010 study on PCMHs, the current review summarizes model initiatives promoted over the past two years, including cost and quality outcomes.

One such PCMH initiative launched in early 2011 by CareFirst — a mid-Atlantic private insurance carrier — garnered nearly $40 million in savings for the Washington metropolitan area during that fiscal year. A 4.2 percent reduction in patient overall healthcare costs among 60 percent of the practices utilizing the model for six months or more was also facilitated by the initiative.

[See also: When implementing PCMH, listen to docs - but talk to them too]

A Florida PCMH program showed similar success — spearheaded by the Capital Health Plan of Tallahassee, this particular sunshine state initiative saw 40 percent fewer inpatient hospital days, 37 percent fewer emergency department visits and an 18 percent reduction from 2003 through 2011 in healthcare claims.

"The evidence is clear, convincing and compelling when you look to both industry reports, as well as the academic literature, that we have really come to a model that offers better care, better quality and lower costs," said Marci Nielsen, MPH, PhD, executive director of the PCPCC, during a press briefing announcing the release of the report.

"Growing support for the PCMH has arisen across the vast majority of the U.S. healthcare delivery system to include more than 90 commercial insurance plans, multiple employers, 42 state Medicaid programs, numerous federal agencies, the Department of Defense, hundreds of safety net clinics, and thousands of small and large clinical practices nationwide," the PCPCC report states. "Major health plans and industry partners are embracing the PCMH model with enthusiasm by creating insurance plans and developing tools and resources contributing to the implementation of medical homes."

Some of the major insurance carriers that have welcomed the PCMH conduct include WellPoint, Aetna, Humana, UnitedHealthcare and various Blue Cross and Blue Shield plans. On the topic of insurance carrier benefits, the report said: "WellPoint predicts that its new PCMH program could reduce its projected medical costs in 2015 by up to 20 percent based on analysis of its current medical home pilot projects. UnitedHealthcare estimates that its new efforts will save twice as much as they cost.”

Among the main report conclusions:
  • The increasing use of the PCMH model is helping to achieve better health, better care and lower costs in the U.S. health care system.
  • PCMH expansion has reached a "tipping point" in the United States and is experiencing broad public and private support.
  •  Investing in the PCMH model results in short-term and long-term savings for patients, their employers, health plans and policymakers.
  • Using the PCMH model to partner with patients and their families could help achieve and sustain transformational change in primary care, as well as in the continuum of care.
[See also: BCBSF rolls out PCMH program statewide]

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