Better together: Medical homes and value-based designs


Patient-centered medical homes are more likely to improve quality of care and reduce costs when they're coupled with value-based insurance designs. Other necessary ingredients include effective clinical information support systems and a strong cross-organization infrastructure, according to a Health Affairs blog post.

Although companies are interested in the concept of medical homes, they're seeking evidence that they can actually achieve promised goals--especially after a February study published in the Journal of the American Medical Association found medical homes might not be as effective as originally hoped.

"They seem to provide an antidote for a healthcare system that typically coordinates care quite poorly," Suzanne Delbanco, executive director of Catalyst for Payment Reform, wrote in the blog. "But at the end of the day, they also want to see a return on investment for the care coordination fees, which today, feel like a cost plus approach."

So insurers must work to educate and offer incentives for their members to obtain primary care from providers participating in medical homes. That could include reduced copays for primary care visits and completely covered drugs to help manage chronic illness.

Insurers also could find more success with medical homes when they target specific populations of expensive consumers. When Health Care Services Corporation teamed up with Boeing, its intensive outpatient care program reduced costs by as much as 20 percent and decreased absenteeism by more than 50 percent, FierceHealthPayer previously reported.

"The program is better than self-funding; it's cost saving," Scott Sarran, chief medical officer of HCSC government programs, told FierceHealthPayer in a previous interview. "This is a sweet spot here in terms of the quality and cost opportunities available. It's a great value creation opportunity."

To learn more:
- read the Health Affairs blog

Related Articles:
Report: PCMH model leads to reduced cost of care, improved population health
Get to know members to achieve value-based success
Medical home must-dos for population health management
Study: Medical homes cut costs for chronically ill members
Medical homes understaffed for teamwork