Evidence for Medical Homes Still Evolving

Joseph Ashwal, MD, knew a good deal when he saw one.

The family physician wanted to take the lead on starting a patient-centered medical home (PCMH) model for his 25-physician practice in Frederick, Md., after reading a nearly 100-page treatise from the area's largest private payer.

The program from CareFirst BlueCross BlueShield -- like so many others -- would pay a bonus for spending extra time with their sicker patients. The money would cover a care coordinator nurse to help oversee these patients' care.

That nurse would help identify the practice's most needy patients, help develop a care plan with their physician, and ensure that the patient saw it through.

"That nurse does a lot of work so the physicians don't have to do it," Ashwal told MedPage Today.

The program -- the Total Care and Cost Improvement Program -- has been a game-changer for Ashwal and his practice, Frederick Primary Care Associates, yielding more than a 20% increase in payments from CareFirst last summer for the group's success during 2011 in lowering spending by keeping patients out of the hospital and emergency departments.

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Source: MedPage Today