CareFirst medical home saves more in second year


In its second year, CareFirst Blue Cross Blue Shield's patient-centered medical home program lowered costs and improved quality care even more than it did in the first year of operation.

Healthcare costs for the 1 million members participating in CareFirst's PCMH, which began in 2011 and is one of the country's largest such programs, totaled $98 million less than the insurer projected, resulting in 2.7 percent savings, according to the announcement.

Most of the savings came from reducing hospital admissions, decreasing emergency room use and lowering drug spending. By comparison, CareFirst's PCMH in 2011 reported cost savings of $38 million or $1.5 percent.

"These results are encouraging," CareFirst CEO Chet Burrell said Thursday in the statement. "It is a measurable and meaningful step in the right direction of slowing the rise of health care costs."

What's more, roughly 66 percent of participating primary care panels, which are groups of independent doctors joined together to participate in the PCMH program, earned incentive payments in 2012, compared to 60 percent in 2011. Those panels received an average 28.8 percent rate increase, the insurer said.

"While the numbers are important, they don't tell the entire story," Burrell said, noting "infrastructure of nursing support, easily-accessible online tools and data, and targeted health programs" are key to CareFirst's PCMH success. Those elements allow the participating primary care providers to better manage and coordinate care.

Burrell said he hopes the PCMH's success encourages even more doctors to participate, especially since CareFirst will increase their incentive payments in 2013. "Right now sitting mid-year 2013, it looks like an encouraging picture," he told the Baltimore Business Journal.

To learn more:
- here's the CareFirst announcement
- see the Baltimore Business Journal article

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