Group Health Cooperative shows investing in more primary care pays for itselfJune 18, 2009Medical home model leads to less emergency room costs and avoidable hospitalizations SEATTLE-An evaluation of recent innovations in delivering primary care at a Group Health Cooperative medical center shows significant success and rapid return on investment. The data led to a decision to invest in these best practices in all of Group Health's 26 medical centers by 2010. "Group Health has for many years focused on delivering quality, coordinated primary care, supported by fully integrated electronic medical records," said Group Health President and CEO Scott Armstrong. "This was an effort to bolster primary care further-and really test what we believe: that excellent, proactive primary care will lead to better health outcomes at lower cost." "At a time when resources are tight, we are so confident in our findings that we are hiring more primary care doctors, physician assistants, and nurses, because we believe this is the best way to achieve our goal of excellent affordable care," Armstrong said. In one year, Group Health's Patient-Centered Medical Home pilot, compared to controls: * Broke even on its primary care staffing investment through reduced downstream utilization costs. Emergency room/urgent care visits were 29 percent less and inpatient hospital stays for patients with conditions including diabetes, chronic obstructive pulmonary disease, congestive heart failure, and asthma were 11 percent less. * Improved indicators of quality of care. Overall improvements were 1.6 times greater across 22 measures than in controls. In seven out of 22 measures, the proportion of people meeting their target went up by more than 5 percent over one year. One example is cholesterol management (LDL less than 100mg/dl) for people with heart disease. * Enhanced patients' experience, including better bonding between patients and their physicians and care teams as well as better care coordination. * Improved care teams' work satisfaction and reduced their emotional burnout. "We saw these improvements in a system and a region that already compare well with the rest of the nation," Armstrong said. "Group Health and Washington state have relatively high-quality care and less overuse of hospitals. The pilot raised the bar even higher." The Patient-Centered Medical Home pilot placed more emphasis on doctors and care teams proactively engaging patients in their health and investing more in care coordination. This resulted in more proactive phone visits, secure e-mailing, and more detailed face-to-face visits. * Physician panel sizes (the number of patients for whom each doctor is responsible) were reduced from 2,300 patients to 1,800 patients. * Appointment times were extended to 30 minutes, from 20 minutes. * Group Health increased its primary care staff by 30 percent to reduce physician-panel size and expand multidisciplinary clinical teams: doctors (family doctors and general internists), physician assistants, nurses, medical assistants, and clinical pharmacists. * Proactive staff-to-patient outreach increased, including clinical team analysis of each patient's needs, communication with the patient days before appointments, and detailed follow-up after it. * Use of e-health technology was maximized, including electronic medical records and increased contact with patients through secure e-mail and phone. * Decreased downstream utilization led to return on investment. "These results lay the foundation for the initial return on investment to be extended in long-term cost savings well beyond the first year," said Michael Erikson, vice president for primary care administration. "We believe the reduction we saw in our care teams' burnout will result in less turnover and recruitment costs for physicians and other clinical staff-perhaps up to $2 million dollars a year, across all recruiting areas for our primary care clinics," he added. "This addresses a fundamental area needed in health care reform to solve the shortage of primary care doctors: drawing physicians to get more opportunity to serve their patients' needs over many years." Group Health Cooperative Center for Health Studies |
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| Related Primary Care Current Events and Primary Care News Articles Trimming US health care spending will require new approaches, study finds Slowing the growth in U.S. health care spending will most likely require adoption of an array of strategies as well as an improved approach to moving promising strategies into widespread use, according to a new analysis by the RAND Corporation. Iowa State engineers develop 3-D software to give doctors, students a view inside the body James Oliver picked up an Xbox game controller, looked up to a video screen and used the device's buttons and joystick to fly through a patient's chest cavity for an up-close look at the bottom of the heart. Study examines quality and duration of primary care visits Adult primary care visits have increased in quality, duration and frequency between 1997 and 2005, according to a report in the November 9 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. Mount Sinai finds those with more difficult to treat forms of HCV are half as likely to get treated A new study by Mount Sinai researchers has for the first time found that patients with more difficult to treat forms of hepatitis C are half as likely to initiate treatment for the disease, when compared to patients with hepatitis C that is easier to treat. Psychiatric impact of torture could be amplified by head injury Depression and other emotional symptoms in survivors of torture and other traumatic experiences may be exacerbated by the effects of head injuries, according to a study from the Harvard Program in Refugee Trauma (HPRT), based in the Massachusetts General Hospital (MGH) Department of Psychiatry. Young tennis players who play only 1 sport are more prone to injuries Gifted young athletes are under increasing pressure to play only one sport year round. Higher health insurance costs force doctors to talk about money with patients As health insurers require people to base more treatment decisions on out-of-pocket costs, physicians should learn to talk to patients about money, according to researchers at Wake Forest University School of Medicine. Survey: Awareness of COPD is rising, but understanding is still low Awareness of COPD-chronic obstructive pulmonary disease-continues to grow in the United States, according to national survey results released today by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Women with chronic kidney disease more likely than men to go undiagnosed Woman are at particular risk of their primary care physicians delaying diagnosis of chronic kidney disease (CKD), according to a paper being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, California. Study spotlights efficacy of questionnaire to identify patients at high risk for lung cancer A study featured in the November issue of the Journal of Thoracic Oncology confirms the success of a simple questionnaire designed to identify patients at high risk of lung cancer. More Primary Care Current Events and Primary Care News Articles |
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