(9). Milstein A and Kothari PP. “Are Higher Value Care Models Replicable?” Health Affairs blog, October 10, 2009. http://healthaffairs.org/blog/2009/10/20/are-higher-value-care-models-replicable/.
- Boeing voluntarily enrolled 740 eligible non-Medicare Boeing employees and dependents with special primary care teams at Everett Clinic, Valley Medical Center IPA, and Virginia Mason Medical Center clinics. Boeing incentivized the groups via a monthly per patient fee to test a new intensified chronic care model, the “ambulatory intensive caring unit” (A-ICU). The pilot produced 20% lower unit price-standardized total annual per capita spending by patients and Boeing, compared to a propensity-matched control group, net of supplemental fees to medical groups 56.5% lower average number of patient-reported work days missed in the last 6 months compared to baseline. In addition, participating employees and dependents experienced improved functioning and improved access to needed care compared to baseline.
- Keywords: Boeing; A-ICU pilot; Intensive Outpatient Caring Unit; primary care; medical home
(10). “Patient-Centered Medical Home” Horizon Blue Cross Blue Shield of New Jersey.http://www.bcbs.com/news/bluetvradio/private-plan-innovation/horizon-blue-cross-blue.html.
- Horizon Blue Cross, working with the New Jersey State Health Benefits Plan and a provider organization (Partners in Care) initiated a medical home pilot with 1300 members with diabetes in 2007, and added an additional 6000 members with diabetes in 2008. Horizon Blue Cross provided the primary care practices with reimbursement for traditionally non-covered services considered to be integral to a medical home. For the first group of patients, Blue Cross reported approximately a 12% reduction in health care costs and for the second group of patients, approximately a 10% reduction. In addition, testing for blood sugar and cholesterol increased dramatically for both patient groups.
- Commentary or lay press
- Keywords: Partners in Care; medical home; Horizon Blue Cross; New Jersey; primary care
(11). “2008 Community Care of North Carolina Evaluation” Mercer Human Resource Consulting. http://www.communitycarenc.com/PDFDocs/Mercer%20ABD%20Report%20SFY08.pdf.
- The North Carolina Medicaid program has paid regionally organized networks of physicians two separate streams of supplemental payments. One goes directly to the practice for practice-based medical home services. The other goes to the regional physician network to support care management, pharmacy consultation, data analysis and general network management. Mercer, the state’s contractor, has reported annual savings each year of the program. Total annual savings to the Medicaid and SCHIP programs were calculated to be $135 million for TANF-linked populations and $400 million for the aged, blind and disabled population in 2008. The veracity of these savings figures have been quested, however. In addition, Mercer reported that 93% of asthmatics received appropriate maintenance medications and diabetes quality measured improved by 15%.
- Non-peer reviewed study
- Keywords: Supplemental payments; primary care; medical home; evaluation; North Carolina; Medicaid; Community Care