Horizon's patient-centered medical home program shows practices need much more than payment changes to transform

Urvashi B. Patel, Carl Rathjen, Elizabeth Rubin

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Skyrocketing costs and the uneven quality of patient care challenge the US health care system. Some health insurance companies are exploring patient-centered medical homes as a way to change incentives and transform the health care delivery system by increasing primary care providers' accountability for care coordination and outcomes. Horizon Healthcare Services, Inc., New Jersey's oldest and largest health insurance company, developed medical home programs that include financial incentives with essential support tools. Our experience in implementing and evaluating various approaches indicates that medical homes require intensive and targeted patient care coordination supported by committed primary care leadership, as well as new payment structures that include a monthly care coordination fee and outcome-based payments. Our experience also indicates that considerable nonmonetary support-such as an education program for population care coordinators, a medical home guide that offers effective ways to transform a practice into a medical home, and useful data sharing-are needed to improve the quality of care and reduce costs.

Original languageEnglish (US)
Pages (from-to)2018-2027
Number of pages10
JournalHealth Affairs
Volume31
Issue number9
DOIs
StatePublished - Sep 2012
Externally publishedYes

Fingerprint

Patient-Centered Care
Delivery of Health Care
Quality of Health Care
Health Insurance
Motivation
Primary Health Care
Patient Care
Costs and Cost Analysis
Population Control
Fees and Charges
Information Dissemination
Social Responsibility
Education

ASJC Scopus subject areas

  • Health Policy

Cite this

Horizon's patient-centered medical home program shows practices need much more than payment changes to transform. / Patel, Urvashi B.; Rathjen, Carl; Rubin, Elizabeth.

In: Health Affairs, Vol. 31, No. 9, 09.2012, p. 2018-2027.

Research output: Contribution to journalArticle

@article{6c60931c2b5440bf93b2262a27e61b50,
title = "Horizon's patient-centered medical home program shows practices need much more than payment changes to transform",
abstract = "Skyrocketing costs and the uneven quality of patient care challenge the US health care system. Some health insurance companies are exploring patient-centered medical homes as a way to change incentives and transform the health care delivery system by increasing primary care providers' accountability for care coordination and outcomes. Horizon Healthcare Services, Inc., New Jersey's oldest and largest health insurance company, developed medical home programs that include financial incentives with essential support tools. Our experience in implementing and evaluating various approaches indicates that medical homes require intensive and targeted patient care coordination supported by committed primary care leadership, as well as new payment structures that include a monthly care coordination fee and outcome-based payments. Our experience also indicates that considerable nonmonetary support-such as an education program for population care coordinators, a medical home guide that offers effective ways to transform a practice into a medical home, and useful data sharing-are needed to improve the quality of care and reduce costs.",
author = "Patel, {Urvashi B.} and Carl Rathjen and Elizabeth Rubin",
year = "2012",
month = "9",
doi = "10.1377/hlthaff.2012.0392",
language = "English (US)",
volume = "31",
pages = "2018--2027",
journal = "Health Affairs",
issn = "0278-2715",
publisher = "Project Hope",
number = "9",

}

TY - JOUR

T1 - Horizon's patient-centered medical home program shows practices need much more than payment changes to transform

AU - Patel, Urvashi B.

AU - Rathjen, Carl

AU - Rubin, Elizabeth

PY - 2012/9

Y1 - 2012/9

N2 - Skyrocketing costs and the uneven quality of patient care challenge the US health care system. Some health insurance companies are exploring patient-centered medical homes as a way to change incentives and transform the health care delivery system by increasing primary care providers' accountability for care coordination and outcomes. Horizon Healthcare Services, Inc., New Jersey's oldest and largest health insurance company, developed medical home programs that include financial incentives with essential support tools. Our experience in implementing and evaluating various approaches indicates that medical homes require intensive and targeted patient care coordination supported by committed primary care leadership, as well as new payment structures that include a monthly care coordination fee and outcome-based payments. Our experience also indicates that considerable nonmonetary support-such as an education program for population care coordinators, a medical home guide that offers effective ways to transform a practice into a medical home, and useful data sharing-are needed to improve the quality of care and reduce costs.

AB - Skyrocketing costs and the uneven quality of patient care challenge the US health care system. Some health insurance companies are exploring patient-centered medical homes as a way to change incentives and transform the health care delivery system by increasing primary care providers' accountability for care coordination and outcomes. Horizon Healthcare Services, Inc., New Jersey's oldest and largest health insurance company, developed medical home programs that include financial incentives with essential support tools. Our experience in implementing and evaluating various approaches indicates that medical homes require intensive and targeted patient care coordination supported by committed primary care leadership, as well as new payment structures that include a monthly care coordination fee and outcome-based payments. Our experience also indicates that considerable nonmonetary support-such as an education program for population care coordinators, a medical home guide that offers effective ways to transform a practice into a medical home, and useful data sharing-are needed to improve the quality of care and reduce costs.

UR - http://www.scopus.com/inward/record.url?scp=84871905148&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84871905148&partnerID=8YFLogxK

U2 - 10.1377/hlthaff.2012.0392

DO - 10.1377/hlthaff.2012.0392

M3 - Article

C2 - 22949451

AN - SCOPUS:84871905148

VL - 31

SP - 2018

EP - 2027

JO - Health Affairs

JF - Health Affairs

SN - 0278-2715

IS - 9

ER -