NCPA - National Center for Policy Analysis


June 9, 2010

An early look at Pennsylvania's experiment in delivering better and, in the long run, less-expensive health care underscores the challenges and potential benefits of one idea being explored as part of the health overhaul.  Known as a "patient-centered medical home," the approach aims to better coordinate care to avoid gaps or overlapping efforts.  The main tenet is that a primary-care provider oversees care with a team of health professionals and coordinates with resources in the community, according to the National Center for Quality Assurance, an independent, nonprofit organization that recognizes practices as "medical homes." 

The approach is designed to provide care in a more structured and organized way than traditional medical practices, but it can involve more personnel and higher costs, at least initially, says the Wall Street Journal: 

  • The health overhaul law is likely to provide funding for pilot projects to investigate the costs and benefits of medical homes.
  • More than a dozen states have already begun conducting their own projects to test whether the approach is feasible and produces the expected results.
  • In the long run, more coordinated care should lower health care costs because patients with better control over chronic conditions won't need expensive emergency care as frequently and inefficiencies (such as redundant tests) will be reduced.  

So far, results have been mixed, says the Journal: 

  • Pennsylvania is carrying out the largest state pilot program in the United States -- called the Chronic Care Initiative -- which involves more than 1 million patients, 800 doctors and 16 insurers across seven regions of the state.
  • Insurers are providing $30 million over three years in extra payment to doctors who are involved and the state is contributing $3.4 million to run the program.
  • In 22 doctors' practices across southwestern Pennsylvania involving 7,500 diabetic patients, the percent of patients with high blood-sugar levels -- a sign that their diabetes isn't in good control -- fell to 24 percent from 29 percent after nine months in the program, according to data from the governor's office presented at a recent meeting in Wexford, Pa.   

Source: Shirley S. Wang, "Pilot Plan on Health an Option for States," Wall Street Journal, June 8, 2010. 

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