Evergreen Hospital announced its selection to participate in the Multi-Payer Medical Home Reimbursement Pilot, a nationwide, model program launched May 1 that seeks to fundamentally improve the quality of primary patient care through leading-edge, preventive medical treatment.
The pilot, which has more than 25,000 patients in Washington, aims to advance patient care through the payment of up-front, care management fees to primary care practices for previously unreimbursed activities, such as care coordination, flexible access to care, tracking and monitoring chronic conditions, preventive outreach and follow-up planning. Evergreen will initially enroll 6,000 patients in the program
"We are always working to find ways to better serve our patients through better outcomes, whether it's through our primary practices or our Emergency Departments and clinics," said John Midtling, MD, executive and medical director of Evergreen Medical Group and program director for the Multi-Payer Pilot, in a press release. "We believe communication with our patients is the cornerstone of this new model of care."
The program, run by the Washington State Health Care Authority (HCA) and the Puget Sound Health Alliance, focuses its efforts on reducing emergency department (ED) visits and hospital admissions by providing incentives for enhanced quality care and improved outcomes, rather than the previous fee-for-services payment model. The program hopes to eliminate 8,300 preventable ED visits, with an estimated cost of $5.5 million.
The pilot is designed to refine the way primary care practices work with patients managing chronic conditions such as diabetes, hypertension and hyperlipidemia. The program expects the reduction in expensive ED visits and hospital admissions to result in system-wide cost savings, which will be split between medical groups and health plans.
"Evergreen has always been a leading organization at the forefront of medical care, with our patients' needs and best interests in mind," said Evergreen Hospital CEO Bob Malte. "The Multi-Payer Pilot program will help us stay on the cutting edge of preventive medicine."
The Multi-Payer Pilot is an outgrowth of the Affordable Care Act of 2010. Washington is one of 19 state pilots. The state's program will run for 32 months and was created in partnership with eight health plans. It will also receive data analysis support regarding quality care metrics, ED visits and hospital admissions from the University of Washington.