Molpus: Medical home is certainly one of those tools that Dave refers to. What are the structures of the medical home that you've put in, particularly the physician components?
Halfen: It all begins with getting the adequate tools in place and adequate times. So there's certain philosophies that make a medical home work, one of which is having people work at the top of their license. We developed an urgent care department and started using more physician extenders for urgent care where those people are seeing patients whose needs aren't as critical, and then the more complicated patients are being seen by the physicians. And then going down further another step from that is putting in a care coordinator who is able to field a lot of questions. The third part is we make the patient part of their care, educating them, letting them know that they can call up 24 hours a day and let us know what's happening with them.
Rice: If you're looking just from the financial side, it starts with the philosophy of pursuing programs that would do what's right for our patients. What we have found, even though there's been a dollar investment in medical home, just the word of mouth and patient satisfaction is worth a lot. We've seen growth of volume and patients wanting to be part of the system because of that word of mouth about having that access and that type of focus on care.
Jeffries: We have somewhere between 10,000 and 14,000 participants in the patient-centered medical home pilot we have with BlueCross. Ours is going to be based on a financial model of the savings against the market trend for total medical cost for the area. Typically in our area it's about 8% a year. And so any savings of that will then be shared equally with BlueCross and with the physician group. And then the physician group, in order to qualify for receiving that bonus, has to meet its quality parameters.