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Patients: Coordinated Physician Care Pilots – Paul Grundy MD, IBM

Dr. Paul Grundy helped organize
the Patient-Centered Primary Care
Collaborative at IBM and serves at its Chair. IBM spends about $1.7 billion a year on
healthcare for its employees and families,
providing coverage for half a million people. The company is working to improve their
healthcare quality, while lowering costs through wellness programs, but believes that more could be accomplished if a critical mass of key
healthcare participants work together to drive even more significant change. Executives believe the Patient-Centered Primary Care Collaborative is a major step towards that goal.   

Many studies have shown that patients with a personal
physician who coordinates their comprehensive care have better outcomes
with lower costs.  We want to make this a reality for patients in the
US. So we joined with the four major primary care physicians’
professional societies, national employers and their associations, quality
advocacy groups, academic centers and consumer advocacy  groups to create the
Patient-Centered Primary Care
Collaborative
. The Collaborative is
advancing a new primary-care-based healthcare model called the \u003cu\>Patient-Centered Medical Home \n(PCMH)\u003c/u\>\u003c/font\>\u003c/a\>\u003cfont face\u003d\”Times New Roman\” size\u003d\”3\”\>. We're also \nworking to \u003cbr\>restructure traditional reimbursement practices, which currently \nincent physician \u003cbr\>specialization. We want to support and reward the \ncomprehensive delivery of \u003cbr\>primary care and expand the role of primary care \nphysicians as patient care \u003cbr\>coordinators. \u003c/font\>\u003cfont size\u003d\”3\”\> \n\u003cbr\>\u003c/font\>\u003cfont face\u003d\”Times New Roman\” size\u003d\”3\”\>\u003cbr\>Last week, we added to our \nmomentum. Aetna, BCBS Association, CIGNA, \u003cbr\>Humana, MVP Health Care, \nUnitedHealthcare, and WellPoint \u003c/font\>\u003ca href\u003d\”http://newsroom.cigna.com/article_display.cfm?article_id\u003d791\” target\u003d\”_blank\” onclick\u003d\”return top.js.OpenExtLink(window,event,this)\”\>\u003cfont face\u003d\”Times New Roman\” color\u003d\”blue\” size\u003d\”3\”\>\u003cu\>announced\u003c/u\>\u003c/font\>\u003c/a\>\u003cfont face\u003d\”Times New Roman\” size\u003d\”3\”\> they \u003cbr\>will support Medical Home pilot \ndemonstrations. \u003c/font\>\u003cfont size\u003d\”3\”\>\u003cbr\>\u003c/font\>\u003cfont face\u003d\”Times New Roman\” size\u003d\”3\”\>\u003cbr\>Together, we want to start one or more pilots \nnext year. Stay tuned! \u003c/font\>\u003cfont size\u003d\”3\”\> \n\u003cbr\>\u003c/font\>\u003cfont face\u003d\”sans-serif\” size\u003d\”2\”\>\u003cbr\>\u003cbr\>Steve\u003cbr\>\u003cbr\>IBM Analyst & \nInfluencer Relations\u003cbr\>Phone 845-677-1017 t/l 320-8929\u003c/font\>\u003cfont size\u003d\”3\”\>\u003cbr\>\u003cbr\>\u003cbr\>\u003c/font\>\n\u003ctable width\u003d\”100%\”\>\n \u003ctbody\>\n \u003ctr valign\u003d\”top\”\>\n \u003ctd width\u003d\”45%\”\>\u003cfont face\u003d\”sans-serif\” size\u003d\”1\”\>\u003cb\>"Matthew Holt" \n <\u003ca href\u003d\”mailto:matthew@matthewholt.net\” target\u003d\”_blank\” onclick\u003d\”return top.js.OpenExtLink(window,event,this)\”\>matthew@matthewholt.net\u003c/a\>>\u003c/b\> \u003c/font\>\n \u003cp\>\u003cfont face\u003d\”sans-serif\” size\u003d\”1\”\>10/19/2007 07:48 PM\u003c/font\>\u003cfont size\u003d\”3\”\> \n \u003c/font\>\u003cbr\>\n \u003ctable width\u003d\”100%\” border\u003d\”4\”\>\n \u003ctbody\>\n \u003ctr valign\u003d\”top\”\>\n \u003ctd width\u003d\”100%\” bgcolor\u003d\”white\”\>\n \u003cdiv align\u003d\”center\”\>\u003cfont face\u003d\”sans-serif\” size\u003d\”1\”\>Please respond \n to\u003cbr\><\u003ca href\u003d\”mailto:matthew@matthewholt.net\” target\u003d\”_blank\” onclick\u003d\”return top.js.OpenExtLink(window,event,this)\”\>”,1]
);
//–><span face="Times New Roman" Patient-Centered Medical Home
(PCMH)
  We’re also
working to restructure traditional reimbursement practices, which currently
incent physician specialization.  We want to support and reward the
comprehensive delivery of primary care and expand the role of primary care
physicians as patient care  coordinators.   
Last week, we added to our
momentum.  Aetna, BCBS Association, CIGNA, Humana, MVP Health Care,
UnitedHealthcare, and WellPoint announced they will support Medical Home pilot
demonstrations.   Together, we want to start one or more pilots
next year.  Stay tuned!  

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SHABBYpaul Grundy MD --Chair PCPCCEdwin EdghillSteve Beller, PhDScott Kozicki Recent comment authors
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SHABBY
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SHABBY

When one compares the U.S. health care system with those of other industrialized countries, one is led to the more specific conclusion that the two major problems in U.S. health care are the way we 1) fail to deliver comprehensive primary care and 2) the way primary care is financed. Our premise is that primary care is the only natural locus of control of health care quality and costs. It is the only entity that is charged with the longitudinal care of the patient. It is the only entity whose job it is to consider the whole patient, the health… Read more »

paul Grundy MD --Chair PCPCC
Guest

First and foremost — Patient Centered Primary Care is an effort to address the high cost/low value situation we find ourselves in as large employer buyers of care. Study after countless study shows that when a patient has a primary care physician that cares about them has and uses the tools to practice comprehensive care centered on the patient needs they get the care they need at a price we can afford. Let’s call that a Patient Centered Primary Care (PCPC) or Patient Centered Medical Home (PCMH). But we the buyers have been part of the problem (as Pogo said… Read more »

Edwin Edghill
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Edwin Edghill

Behavioral health care has been left out of this initiative. Since 60%-70% of all visits to primary care have no biological basis, this is an oversight. The current methods for managing behavioral health through tight supply side mechanisms drive, most people to traditional medicine. We have generated huge savings, freed MD time and the satisfaction scores from pts and MDs are over 97% by properly educating and implementing mental health professionals inside primary care.

Steve Beller, PhD
Guest

The medical home model is a good way to replace one of our negative healthcare system processes, which fails to deliver value to patient for many reasons, with a positive patient-centered process. I discuss this in a series of posts on my blog about the Patient-Centered Life-Cycle Value Chain strategy.

Scott Kozicki
Guest
Scott Kozicki

Not one comment about this? Really???