More ev­i­dence piles up

Sav­ings com­ing from re­duced hos­pi­tal care

Modern Healthcare - - Cover Story - Andis Robeznieks

The med­i­cal home de­liv­ery model, while in­creas­ingly pop­u­lar, for a long time lacked the data its sup­port­ers needed to prove their case that the con­cept could de­liver on the prom­ise of qual­ity im­prove­ment and long-term sav­ings.

There were only two stud­ies early on they could point to: A 2007 re­port in Health Af­fairs show­ing how med­i­cal homes helped Danville, Pa.-based Geisinger Health Sys­tem re­duce hos­pi­tal ad­mis­sions by 20% and cut med­i­cal costs by 7%, and how, af­ter an ini­tial $10.2 mil­lion in­vest­ment, sav­ings of $244 mil­lion were recorded for North Carolina’s Med­i­caid sys­tem in 2004.

Now the data is rolling in from other pi­lot projects, and it sup­ports the idea that much of the sav­ings from med­i­cal homes is com­ing from re­duced hos­pi­tal care. New ex­am­ples of the qual­ity-im­prov­ing, cost­low­er­ing ef­fec­tive­ness of the med­i­cal home model re­ported by the Pa­tient-Cen­tered Pri­mary Care Col­lab­o­ra­tive in­clude data from Seat­tle-based Group Health Co­op­er­a­tive. Ac­cord­ing to a May 2010 Health Af­fairs ar­ti­cle, the sys­tem re­ceived $1.50 for ev­ery $1 it in­vested in im­ple­ment­ing the med­i­cal home model it be­gan pi­lot­ing in 2006—thanks in part to sav­ings from a 29% re­duc­tion in emer­gency depart­ment vis­its, 11% re­duc­tion in “am­bu­la­tory sen­si­tive care” ad­mis­sions, and 6% fewer hos­pi­tal­iza­tions over­all.

The col­lab­o­ra­tive also re­ports how fewer emer­gency vis­its and hos­pi­tal­iza­tions low­ered costs for chil­dren en­rolled in Med­i­caid and the State Chil­dren’s Health In­surance Pro­gram in Colorado. It re­ported that the me­dian an­nual med­i­cal cost for chil­dren see­ing physi­cians par­tic­i­pat­ing in the Colorado Depart­ment of Health Care Pol­icy and Fi­nanc­ing’s med­i­cal home pro­gram was $785 com­pared with $1,000 for con­trol pa­tients. When look­ing specif­i­cally at Den­ver chil­dren with chronic con­di­tions, the me­dian costs were $2,275 for pa­tients see­ing med­i­cal home-af­fil­i­ated doc­tors com­pared with $3,404 in the con­trol group.

Re­cent find­ings on med­i­cal home sav­ings were re­leased Oct. 25 by Blue Cross and Blue Shield of South Carolina, which re­ported the 809 di­a­betic pa­tients en­rolled in the 22-site, 55-provider med­i­cal home pi­lot it de­vel­oped with Sum­merville-based Palmetto Pri­mary


Har­beck: Med­i­cal homes of­fer “bet­ter dol­lars for the doc­tor.”

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