Empire announces launch of Patient Centered Medical Home pilot

For many people with chronic health conditions, it can be tough to navigate through the complex healthcare system. Mary, a 65 year old woman with several conditions including diabetes, arthritis, high blood pressure and high cholesterol, visits specialists for each of these conditions - an endocrinologist, rheumatologist and cardiologist - in addition to her primary care physician. Without overall organization of care, people like Mary, are left to manage their conditions on their own - with no big picture health perspective, wellness regimen or coordinated treatment plan.  

Today, Empire BlueCross BlueShield ("Empire") is announcing the launch of a Patient Centered Medical Home pilot, which is designed to help ensure that people like Mary have improved access to health care services - where care is personalized and coordinated. A Patient Centered Medical Home is designed to facilitate medical management of the "whole person" rather than a specific health condition. This two year pilot includes 300 physicians and is open to all patients being treated in a medical practice involved in the pilot. Over 39,000 members are expected to be touched by this pilot.  

A Patient Centered Medical Home is a medical practice in which a team of physicians and health practitioners collectively takes responsibility for the ongoing care of its patients. Enhanced access and communication, including a written patient summary after every visit and 24/7 access to care, helps patients in these practices better understand their condition and provides a single point of contact. Referrals to specialists, tests results and adherence to national standards of care are tracked and monitored with the goal of better managing disease and enhancing prevention and wellness.

"What Empire and its partners plan to do through this pilot is create a new model of health care delivery – one in which care is better coordinated and meets the needs of the patient; one that moves beyond episodic based healthcare interventions to a focus on patient safety, wellness and prevention; and, one in which a patient's medical experiences are documented and in one repository, rather than scattered ineffectually throughout the system," says Mark Wagar, President and CEO, Empire BlueCross BlueShield. "We believe this pilot represents health care reform in the truest sense and that it will reduce the medical costs that continue to drive up insurance premiums."

HealthCore Inc, a healthcare research firm and affiliate of Empire's, will conduct a study to measure components of the pilot such as physician and patient satisfaction, improved health outcomes and reduced health care costs associated with reduced emergency room visits and hospitalizations. Daniel Halevy, MD, FASN, Executive Director of Medical Quality for NYC REACH agrees, "We recognize the importance of coordinated patient care models like the medical home in order to improve health care quality and reduce disparities."  WESTMED Medical Group "strongly believes the advanced primary care model of the Medical Home emphasizes the patient centered perspective and reasserts the important responsibility and coordinating role of the primary care physician.  This enhances the doctor/patient relationship and provides patients with a higher level of quality and patient satisfaction."  

The pilot, which was launched on July 1, 2010, includes multiple partners, including the New York City Department of Health and a broad spectrum of faculty and community based primary care practices throughout New York City and the downstate region.  Physicians are enthusiastic about the potential this program holds for improving their patients' care. "Allied Pediatrics of New York (APNY) unanimously endorses Empire's foresight in promoting the medical home and recognizing the importance of the primary care pediatrician's role in ensuring that medical care is delivered in a safe, timely and efficient manner," says Gary Mirkin, MD, APNY. Salvatore Volpe, MD, adds, "As a solo practice, we are very proud to be part in this program. We believe it has the potential to improve the care of patients and keep primary care practices viable."