North Carolina employers have a chance to help improve patient care and save healthcare costs thanks to First in Health, a public-private partnership that will make it possible for them to tap into a medical home created for Medicaid recipients that has helped improve care while saving more than $1 billion.
North Carolina employers have a chance to help improve patient care and save healthcare costs thanks to First in Health, a public-private partnership that will make it possible for them to tap into an IT-supported medical home created for Medicaid recipients.
First in Health created the medical home on behalf of the State of North Carolina. Partners in the First in Health effort include Community Care of North Carolina (CCNC), GlaxoSmithKline (GSK), the State Health Plan of North Carolina (SHP), local pharmacy chain KERR DRUG, business analytics company SAS and Blue Cross and Blue Shield of North Carolina (BCBSNC), the state's largest health insurer.
They are joining forces to promote medical homes, change the way care is delivered and demonstrate that increasing the focus on managing chronic diseases, which account for 75 percent of the nation's healthcare spending, can improve outcomes and hold down costs. The partnership, which is unprecedented in size and scope given CCNC's network, was announced at the annual meeting of the N.C. Institute of Medicine.
CCNC is known for providing the state's Medicaid program with "on the ground" care management, health information technology infrastructure and population-based health initiatives that have raised quality and saved Medicaid nearly $1.5 billion over three years.
[See also: Highmark launches medical home pilot]
CCNC's performance is in the top 10 percent nationally in HEDIS measures for diabetes, asthma and heart disease, compared to private Medicaid managed care organizations. Now, private sector companies are joining the effort in hopes of realizing similar quality and cost-saving benefits for employees, their dependents and retirees. The Brookings Institution, a nonprofit public policy organization based in Washington, DC, will evaluate the program's impact on cost and quality.
"CCNC has shown that effective primary care – supported by 'high-touch' care management, solid healthcare IT and population-based quality improvement – can be a game changer that saves money and dramatically improves the quality of healthcare received by patients," said CCNC President L. Allen Dobson, MD.
First in Health builds on several federal demonstration projects already under way across much of North Carolina including the Beacon Communities program, Medicare 646 waiver and the Multi-payer Advanced Primary Care Practice initiative (MAPCP), a demonstration program of the Centers for Medicare and Medicaid Services (CMS). All of these feature on-the-ground local care managers, population-based initiatives, and a broad cross-section of public and private payers linked by health information technology to provide services to 1.1 million North Carolinians.
GSK will begin offering its employees in North Carolina the option of joining a medical home beginning in January 2012. Employees from GSK will have the option of adding the First in Health benefit to their existing health benefits. GSK will waive copayments for primary care doctor visits for employees choosing this option and pay participating doctors a "per member, per month" fee for each GSK employee assigned to a medical home. These resources will fund an enhanced level of care coordination including improved HIT and "high-touch" assistance from local care managers.
The State of North Carolina will begin offering employees access to CCNC medical homes in targeted counties in the fall of 2011. SHP plans to offer the option to 400,000 enrollees in 100 North Carolina counties within two years of launch through a cooperative agreement with Active Health Management.
KERR DRUG is working through its benefit process with an eye towards offering employees access to medical homes in the company's 2013 benefit year. KERR DRUG brings to the partnership extensive experience in collaborative efforts to provide education and personal oversight to North Carolinians with chronic health problems.
SAS brings to First in Health sophisticated analytical tools, experienced health data consultants and support for a detailed evaluation of First in Health's medical home approach.
BCBSNC is a major partner in North Carolina's seven-county MAPCP demonstration that integrates efforts of public and private payers to lower costs and improve health care quality. BCBSNC is also involved in the Model Practice project, a collaboration with UNC Healthcare to create an expanded medical home model that better coordinates patient care and enables teams of health care providers to work collaboratively with patients and families in delivering high quality care.