Representatives from seven major health plans are working with four major physician groups to see if they can firm up the 'medical home' model of care. The coalition will conduct as many as 100 pilot projects designed to have primary care physicians coordinate ongoing care, rather than patients undergoing a series of episodic treatments.
Of course, that's the way the primary care role is supposed to work, but it often doesn't, particularly given that insurance reimbursement doesn't favor this approach. Provider groups involved in the initiative, including the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians and the American Osteopathic Association, hope to address this reimbursement issue as much as clinical management concerns.
Health plans on board for the initiative include Aetna, Blue Cross and Blue Shield Association, CIGNA, Humana, MVP Health Care, UnitedHealthcare and WellPoint. While plans like these have been reluctant to get involved in these projects in the past, it will be interesting to see if this is a turning point. After all, in theory, isn't giving patients a medical home central to the philosophy of managed care? (Or is there something they're not telling us about their real incentives?)
To find out more about the pilots:
- read this Modern Healthcare piece
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