Medical Home Pilot Initiatives Continue to Expand Nationwide

June 8, 2009

Charleston, S.C. and Rochester, N.Y. Among Latest Markets with Pilot Projects Underway, According to New Reports from HealthLeaders-InterStudy

NASHVILLE, TN – June 8, 2009 – HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that medical home pilot initiatives across the country will be under heavy scrutiny as stakeholders determine whether such programs can save money by directing care more efficiently. According to the recent North and South Carolina Health Plan Analysis, BlueCross BlueShield of South Carolina and Palmetto Primary Care Physicians are working together to improve diabetes care with a medical home pilot in the greater Charleston area.

Their year-long effort is a first for South Carolina and seeks to decrease duplicate testing, increase medication compliance and improve adherence to evidence-based guidelines. About 1,500 Charleston-area Blue plan members with diabetes are enrolled in the program, which was developed in partnership with Merck.

The medical home concept relies on a team-based approach where a primary-care physician provides coordinated care throughout a patient’s lifetime, including preventive services and the treatment of acute and chronic illness.

In the Rochester market, there is another type of medical home pilot underway. According to the recent TriState Health Plan Analysis, Excellus Blue Cross Blue Shield and MVP Health Care are working together to build the first medical home pilot project for that region. By transforming adult primary-care physician practices into patient-centered medical homes, the initiative hopes to reverse the growing shortage of primary-care physicians in the area, while restructuring the payment system.

The medical home pilot initiatives in the Charleston, S.C. and Rochester, N.Y. markets are just two examples of how this approach to care continues to gain traction, said Heather Johnston, market analyst with HealthLeaders-InterStudy. With increased focus on reducing medical waste and improving quality, the outcomes of these pilots will be closely monitored to see whether they may provide models that can be replicated throughout their regions.

The medical home model has also grown increasingly popular in state Medicaid programs, with more than half of state programs testing the model for at least a portion of their members. Recent HealthLeaders-InterStudy reports for Florida and Wisconsin outline such initiatives underway in those states.

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