Balancing health care tailored to the individual with a modern reimbursement scheme based on population health is the challenge that awaits the nation's healthcare system. Based on a study in The American Journal of Managed Care, it can be done, even among patients like seniors who use more healthcare than most.
Personalized Preventive Model Brings Savings for Medicare Advantage, AJMC Study Finds
PLAINSBORO, N.J. — Spending extra time with Medicare patients upfront to identify those at risk for serious healthcare events saves money, as these patients use less health care down the road. This is what researchers led by Shirley Musich, PhD, and Andrea Klemes, DO, found in a study of Medicare Advantage patients, which has just been published in The American Journal of Managed Care.
The study examined a model, MDVIP (MD-Value in Prevention), which involved a network of primary care physicians who deployed a specialized physician-patient relationship, one that limited the size of the practice to 600 patients per physician. This allowed for same-day or next-day appointments, even when patient needs were not urgent. Patients also had the ability to reach their physician 24 hours a day. These practices focused on prevention, wellness and coordination of care, with longer visits, proactive prevention, and an emphasis on answering questions.
Compared with patients not enrolled in the prevention program, those in preventive care experienced a savings of $1040 per patient in the first year and $564.36 per patient in the second year, the study found. These results suggest the model should be applied on a wider scale.
The authors note that to date, the Centers for Medicare and Medicaid Services (CMS) has focused its savings efforts on those patients who are very sick, but not on the relatively healthy Medicare beneficiaries who nonetheless have risk factors that warrant attention. “The results demonstrated that a model of personalized preventive care delivery can reduce spending among Medicare Advantage beneficiaries,” the authors wrote. As Medicare officials look for savings, extra attention might not only be good for patients, it might save money, too.
“What drives this model is the relationship between the doctor and the patient, which allows for earlier identification of risk and better outcomes,” said Dr. Klemes, Chief Medical Officer, MDVIP. “We have shown that focusing on prevention and wellness in Medicare Advantage patients can keep them from being seen in the Emergency Room and admitted to the hospital both of which take up more healthcare resources.”
About the Journal
The American Journal of Managed Care, now in its 20th year of publication, is the leading peer-reviewed journal dedicated to issues in managed care. Other titles in the AJMC family of publications are The American Journal of Pharmacy Benefits, which provides pharmacy and formulary decision makers with information to improve the efficiency and health outcomes in managing pharmaceutical care. In December 2013, AJMC introduced The American Journal of Accountable Care, which publishes research and commentary devoted to understanding changes to the healthcare system due to the 2010 Affordable Care Act. AJMC’s news publications, the Evidence-Based series, bring together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in the areas of oncology, diabetes management, and immunology and infectious disease. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.
About MDVIP, Inc.
MDVIP, Inc. is the national leader in affordable personalized healthcare. With prevention at the center of its program, MDVIP has proven that its carefully chosen affiliated physicians provide exceptional care and achieve exceptional outcomes. Published results include lower hospitalization rates which yield significant cost savings to patients, employers and the healthcare system. MDVIP-affiliated physicians limit their practices to no more than 600 patients in order to provide a customized wellness and preventive care program. There are currently over 700 MDVIP-affiliated physicians in the network throughout the country. MDVIP, Inc. was founded in 2000 and is headquartered in Boca Raton, Florida. For more information, visit www.MDVIP.com.
CONTACT: Mary Caffrey (609) 716-7777 x 144