Patient Centered Medical Home Summary

1236 WordsNov 21, 20105 Pages
Overview of the Patient Centered Medical Home project piloted by Geisinger Health System in Danville, Pennsylvania Date: October of 2010  Goal: Create value (defined as outcomes relative to input costs), measure innovation returns, and receive market rewards.  Requirements: a multidimensional transformation of primary care practice with intensive case management and a payer partnership.  Coordinating Primary Care/Team Effort: “patient Centered Medical Home” Geisinger calls it “Personal Health Navigator” aims to help patients manage all the complexities of their care in one setting. Focus on putting patients/families at the center of care. Doctors, nurses, technicians and case managers (who coordinates it all). Constantly…show more content…
In addition, an incentive pool is created based on differences between the actual and expected total cost of care for medical home enrollees (contingent on quality indicators). To encourage team-based care/support, incentive payments are split between individual providers and the practice.  Financial Incentives for Primary care: Comparison costs of practices using PCMH model to those that do not and achieved savings (by reducing hospital admissions and unnecessary tests, they can get half $ back. The catch is that they only get the $ if they’ve met a whole checklist of quality measures for preventive care, chronic disease management and so on. Primary Care is rewarded for efficiency without sacrificing quality. Half of savings goes to Geisinger’s own health plan that funds extra services and creates medical homes. The health plan earned 2.5 times its R.O.I. back in the first year.  Monthly performance reports: Reviewed at the practice site. Identify and rapidly spread best practices.  Early pilot-site results: Primary target is reduced hospital use. Their data show a reduction in all-cause admissions and medical cost savings.  Chronic Disease Care Optimization: DM, CHF, CKD, CAD, HTN, and preventative care. Clinical practices are standardized using a newly developed nursing tool to capture and summarize information before the patient enters the exam room. Tracks performance using an “all-or-none bundle approach.” Bundle Example for
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