It was a bumpy road, but leaders from Colorado's patient-centered medical home pilot say the effort seems to have reduced emergency-department visits and hospitalizations, especially among patients with chronic disease.
Coordinated by HealthTeamWorks, a Lakewood, Colo.-based not-for-profit organization, the Colorado multipayer patient-centered medical home pilot ran from May 2009 through April 2012. Six health plans, including Aetna and Cigna Corp., agreed to participate under an enhanced compensation model that blended fee-for-service, monthly per-member care-management fees and pay-for-performance payments.
Final results are pending, but preliminary data is encouraging, according to an article in Health Affairs
. In addition to lower ER visit and hospital admission rates, one of the payers reported a return on investment of 250% to 400%. And the participating practices, which have approximately 100,000 patients, improved their use of team-based care, health information technology and care coordination.
But the pilot faced a wide range of challenges, including antitrust laws, problems with reporting data and health plans that sometimes failed to comply with obligations.
The authors advised a number of safeguards, including the use of complex-care managers; an agreed-upon measurement and payment structure used by all participating payers; and increased price transparency.
“We hope that payers and providers can use our experiences to inform their initiatives, address or prevent obstacles and enable long-term success," they said in the report.