Medical homes cut costs for chronic conditions


Patient-centered medical homes (PCMH) could be the answer to keeping chronic care costs in check, according to an analysis from Independence Blue Cross (IBC).

IBC's three-year studies evaluated 125,000 individuals receiving primary care in 160 medical homes between 2008 and 2012 and found a 21 percent lower cost of care for diabetic members in a PCMH, thanks in part to a 44 percent drop in hospital costs, the Philadelphia insurer announced Tuesday.

The studies also showed lower emergency room costs after one year, as well as lower costs for chronically ill members with coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, asthma and hypertension.

PCMHs not only lowered chronic care costs, they also improved chronic disease self-management. Diabetic patients in PCMHs had a 60 percent improvement in getting bad cholesterol under adequate control while the number of patients with poorly controlled diabetes fell 45 percent, the study found.

"The doctors and their staff in medical homes don't just address the health needs of their patients when they are in the office," IBC Chief Medical Officer Richard Snyder said in the announcement. "They monitor care between appointments to make sure patients are getting the tests they need and are taking their medications as prescribed. And it's making a big difference."

Healthcare organizations don't need a full-fledged PCMH to start seeing similar results. Even partial, incremental implementation of medical home features, such as use of care coordinators and disease registries, can lead to high-quality, low-cost care, according to a July analysis of Blue Cross Blue Shield of Michigan's PCMH program.

Those organizations looking to embrace the patient-centered medical home model should note the transformation will continue for years, Snyder told FierceHealthPayer in an April interview.

"The practices that I've talked to, including Thomas Jefferson University Hospital residency program, view it as an ongoing transformation. They're in their fifth year and still continue to make changes and add features that strengthen their engagement with their patients," he said.

For more:
- here's the announcement
- check out the IBC interview

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