Jeffrey Seguritan at Nuts For Healthcare has written a very informative article about a “medical home” pilot program that UnitedHealth is undertaking, together with IBM. When I scrolled through the article and saw that Colorado is one of the states where UnitedHealth is funding a pilot program this year, I was intrigued and read the article.
Over the last couple years, we’ve heard plenty about how the primary care system in this country is broken. PCPs make far less money than their specialist colleagues, and very few new doctors are choosing to become PCPs. The reimbursement system is fraught with headaches, and healthcare costs continue to soar while our outcomes don’t really improve from one year to the next.
So it’s nice to see two big companies – IBM and United – teaming up to try out a new approach. From Seguritan’s article, it looks like the program here in Colorado isn’t the primary focus right now, but I’m glad to see that it’s underway.
In the “medical home” model, a patient works with a small group of doctors who coordinate treatment and provide holistic care. The approach is designed to eliminate the under-treatment that sometimes occurs when doctors are just given a set fee to treat a patient, regardless of how much care is actually provided. And it’s also set up to eliminate the over-treatment that can occur in a fee-for-service model, where doctors are reimbursed for every visit and test, regardless of how successful the treatment is. The early indications of the medical home model indicate that it’s a win-win for everyone: PCPs make a little more money (still far less than specialists, but any boost would probably encourage more new docs to enter the profession), fewer patients are hospitalized, overall costs go down, and patient satisfaction goes up.
I’m curious to see what the outcome is for the IBM/United medical home pilot program. We work with United Healthcare here in Colorado, and are eager to see if United can come up with a program that would ultimately lead to lower healthcare costs (and thus lower health insurance premiums). If the pilot is successful, I imagine we’ll see other health insurance companies implementing similar medical home programs.
I found Seguritan’s article in the Health Wonk Review, published this week at Medicaid Front Page by Brady Augustine.
