Horizon's patient-centered medical home program shows practices need much more than payment changes to transform.

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  • Author(s): Patel UB;Patel UB; Rathjen C; Rubin E
  • Source:
    Health affairs (Project Hope) [Health Aff (Millwood)] 2012 Sep; Vol. 31 (9), pp. 2018-27.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Project Hope Country of Publication: United States NLM ID: 8303128 Publication Model: Print Cited Medium: Internet ISSN: 1544-5208 (Electronic) Linking ISSN: 02782715 NLM ISO Abbreviation: Health Aff (Millwood) Subsets: MEDLINE
    • Publication Information:
      Publication: : Bethesda, MD : Project Hope
      Original Publication: Millwood, Va. : Project Hope, c1981-
    • Subject Terms:
      Patient-Centered Care/*organization & administration ; Primary Health Care/*organization & administration ; Reimbursement Mechanisms/*organization & administration; Humans ; Leadership ; New Jersey ; Organizational Case Studies ; Organizational Innovation ; Patient-Centered Care/economics ; Primary Health Care/economics ; Social Responsibility
    • Abstract:
      Skyrocketing costs and the uneven quality of patient care challenge the US health care system. Some health insurance companies are exploring patient-centered medical homes as a way to change incentives and transform the health care delivery system by increasing primary care providers' accountability for care coordination and outcomes. Horizon Healthcare Services, Inc., New Jersey's oldest and largest health insurance company, developed medical home programs that include financial incentives with essential support tools. Our experience in implementing and evaluating various approaches indicates that medical homes require intensive and targeted patient care coordination supported by committed primary care leadership, as well as new payment structures that include a monthly care coordination fee and outcome-based payments. Our experience also indicates that considerable nonmonetary support-such as an education program for population care coordinators, a medical home guide that offers effective ways to transform a practice into a medical home, and useful data sharing-are needed to improve the quality of care and reduce costs.
    • Comments:
      Comment in: Health Aff (Millwood). 2012 Nov;31(11):2593. (PMID: 23129693)
    • Publication Date:
      Date Created: 20120906 Date Completed: 20130107 Latest Revision: 20120905
    • Publication Date:
      20231215
    • Accession Number:
      10.1377/hlthaff.2012.0392
    • Accession Number:
      22949451