Payers to Test Medical Home Model

HDM Breaking News, January 10, 2008

Two affiliated health insurers serving the greater New York metropolitan region will conduct a pilot program of the Medical Home model to better coordinate patient care.

Among other factors, the model advocates extensive use of information technologies to document and coordinate care across all providers and settings, support evidence-based medicine through decision support tools and conduct performance measurements.

Group Health Inc. and Health Plan of New York will launch theMedical Home High Value Network to help adult primary care practices become Medical Home Practices. The program is supported by a grant from the Commonwealth Fund in New York. Patients will have electronic connectivity to their providers via e-mail and appointment calendars, and also will have access to clinical decision support tools.

Participating physician practices will be divided into a support group and a comparison (or control) group. Each group will comprise 25 adult care primary practices.

The supported group will be paid using revised payment methodologies and will receive technical support for office redesign and care management. Data to evaluate success of the Medical Home model will come from claims and performance measures of quality for such procedures as mammograms, diabetes testing and cervical cancer screenings; outcomes for diabetes and hypertension care; efficiency measures and patient satisfaction scores.

The Ethel Donaghue Center for Translating Research Into Practice and Policy at the University of Connecticut will assess the experiences and challenges as physician practices transform into Medical Homes. Results will be published at the end of the two-year project.

Group Health Inc. and Health Plan of New York serve more than 4 million members in New York, Connecticut and Massachusetts. The insurers affiliated as EmblemHealth Inc. in 2006 as a first step toward a full merger. More information on the Medical Home High Value Network will be posted at ghi.com and hipusa.com.

Several medical societies, business associations, employers and insurers in 2007 formed the Patient-Centered Primary Care Collaborative to advocate the Medical Home model. More information is available at patientcenteredprimarycare.org.

For more information on related topics, visit the following channels:

• Business Intelligence
• Consumer Health
• Decision Support
• Disease Management
• Group Practices