New Jersey and Arizona physicians will be transforming their practices into patient-centered medical homes in 2009 as part of statewide PCMH pilots.
In the PCMH model, primary care physicians partner with patients to understand their needs and preferences, manage their healthcare and facilitate any care needed from other professionals. The model places special emphasis on preventing disease and improving the care of chronic conditions and emphasizes behavioral health support and patient education.
The pilot program in New Jersey is a collaboration between Horizon Blue Cross Blue Shield of New Jersey and the New Jersey Academy of Family Physicians (NJAFP). The year-long program will be implemented in 25-50 practices.
"The PCMH concept emphasizes the 'high-touch' nature of primary care that family physicians have traditionally provided to patients," said Ray Saputelli, executive vice president of the NJAFP.
Horizon BCBSNJ will provide seed funding to support the infrastructure of the pilot program.
"The Patient Centered Medical Home has already shown great promise in helping improve the outcomes of people struggling with chronic illnesses and we expect similar results with this program," said Richard Popiel, vice president and chief medical officer of Horizon BCBSNJ.
In Arizona, the program will be open to UnitedHealthcare's employer-sponsore Medicare Advantage and Medicaid health plan customers, including four to six primary-care practices from UnitedHealthcare's physician network in Phoenix and Tucson.
Selected practices will be provided with technology, infrastructure support and care coordination, with the goal of leveraging improved information systems to enhance patient access to care, the quality and safety of the care experience and patient satisfaction with healthcare providers.
"We believe the Patient-Centered Medical Home model enhances the delivery of higher-quality, more coordinated care while improving outcomes and reducing healthcare costs," said Dawn Bazarko, RN, UnitedHealthcare's senior vice president of clinical innovation.
Primary-care physicians providing care based on the PCMH model stand to receive enhanced reimbursement in recognition of care coordination and improvements to access, communications, delivery of preventive and chronic care and patient experience and satisfaction.
"We... know that established and continuous access to a personal primary-care physician who really looks out for the whole person and not just a disease is proven to produce materially better health outcomes at lower costs," said Martin Sepulveda, MD, vice president of integrated health services at IBM, a partner in the Arizona project. "Still, our system in the United States is allowing the professionals trained to deliver this type of care to decline precipitously."