UnitedHealth Group Begins Pilot Program in Arizona To Test Medical Home Model of Health Care
UnitedHealth Group, at the request of IBM, has partnered with seven medical groups in Arizona on a pilot program that will test the viability of the "medical home" model of health care, the New York Times reports. In Arizona, UnitedHealth serves as the only health insurer for IBM and covers about 11,000 company employees and their dependents. The program, which will continue through 2011, will involve about 7,000 patients of 26 physicians from the seven medical groups. The patients include a small fraction of IBM employees, as well as Medicare and Medicaid beneficiaries enrolled in UnitedHealth plans.UnitedHealth will give physicians additional authority over patient care decisions and higher payments for more closely monitoring patients' progress, regardless if they are being treated by specialists or hospitals. UnitedHealth will hire consultants from a for-profit company managed by the American Academy of Family Physicians to help physicians change their practices to improve care for patients. Physicians will continue to receive payments from UnitedHealth based on the services that they provide but also will receive a quarterly management fee and bonus payments when they meet certain quality measures.
UnitedHealth and IBM officials said that physicians can increase their overall revenue by as much as 30% under the program. In addition, UnitedHealth officials said that they expect double-digit decreases in hospital stays and emergency department visits as a result of the program. UnitedHealth did not disclose the cost of the program, but the company has spent more than a combined $1 million on three medical home programs. UnitedHealth also recently ended a similar program in Florida because of a lack of support from physicians in the state.
Medical Home Model
According to the Times, the medical home model of health care is based on the "theory ... that by providing a home base for patients and coordinating their treatment, doctors can improve care, prevent unnecessary visits to the emergency room, reduce hospitalizations and lower overall medical spending." The model also "is meant to fix some of the major shortcomings of how health care is delivered" and funded in the U.S., as health insurers "typically reward doctors for how much they do -- how many tests or procedures they perform -- rather than how effective their care is," the Times reports.
However, some health care policy experts "worry that the push for medical homes could be yet another example of the latest health care fad -- quickly embraced by employers desperate to slow their soaring health costs, and just as quickly forgotten when they do not provide immediate results," according to the Times (Abelson, New York Times, 2/7).
