PCMH Data Certifies Proof of Concept

John Commins, for HealthLeaders Media , January 15, 2014

Diabetes Care Results
The Colorado Multi-Payer PCMH Pilot Model that focused on diabetic care posted particularly impressive result over three years, which included:

  • A 15% reduction in ED visits, compared with 4% for a control group;
  • 18% fewer inpatient admissions compared to an 18% increase for the control group;
  • No increase in specialty referrals compared with 10% increase for the control group; and
  • A return on investment ranging from 2.5:1 to 4.5:1 for every dollar spent by WellPoint on the pilot.

In addition, 95% of the patients said the care was efficient and well organized and 97% said they would recommend the program to family and friends.

The Blue Cross Blue Shield of Michigan Physician Group Incentive Program reported that practices with full PCMH implementation had savings of $26.37 per patient per month and a 5.1% higher "prevention composite score" than colleagues in traditional practice settings. 

While not every PCMH pilot can claim these levels of success, virtually every pilot examined by the Collaborative demonstrated improvements over the traditional fee-for-service practice model that provides incremental, episodic care and incentivizes volume.

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