Results driven largely by lower inpatient costs, which fell by 44 percent
Philadelphia, PA – Results from a three-year study by Independence Blue Cross (Independence) demonstrating reduced medical costs for diabetic patients cared for by patient-centered medical home practices appears in the Journal of Public Health Management and Practice. The study involved nearly 4,000 Independence members: half were treated by doctors in medical home practices and half were treated in practices that were not medical homes.
In the study from 2008 to 2011, the group of diabetic patients treated in primary care practices that made the commitment to transform into a medical home had reduced overall medical costs by 21 percent in the first year. This reduction was driven largely by a reduction in inpatient costs, which fell by 44 percent.
In subsequent years, the patients in medical homes had 34 percent fewer emergency department visits, 18 percent fewer specialist visits, and outpatient costs dropped by 32 percent. This is the second published paper by Independence Informatics showing the benefits of medical homes for those with chronic conditions. The first paper was published on March 24 in the The American Journal of Managed Care.
“We’ve found that medical homes are particularly beneficial to diabetics because of added resources such as care managers and dieticians that provide regular outreach, test reminders, and preventive care,” said Richard Snyder, MD and chief medical officer at Independence. “Not all care happens in the doctor’s office. Regular outreach by a nurse or another health professional is very important to help prevent an ER visit or improve someone’s quality of life. Diabetes is a major cause of kidney failure, heart disease, and blindness and finding ways to better manage the disease and prevent these other devastating health problems is a national health priority.”
“Medical homes encourage patients to become more engaged managing their illness, for example, making sure diabetics get regular blood tests, foot and eye exams, and take their medication as directed. These are critical behaviors to effectively manage that disease,” said Somesh Nigam, Independence’s chief informatics officer and a contributor to the study. “One of our study results showed a drop in prescription drug costs for patients with non-insulin dependent type 2 diabetes, which we believe can be attributed to more diabetic patients doing positive things to manage their diabetes, like watching their weight and exercising.”
Practices which achieve recognition as a medical home from the National Committee for Quality Assurance (NCQA) — a private, non-profit organization dedicated to improving health care quality — deliver more coordinated care, measure their own performance, and hold themselves accountable for creating better access to care, and delivering better outcomes and a better experience for their patients and their families.
Patient-centered medical homes are one part of Independence’s comprehensive strategy to better serve its customers by increasing the quality and reducing the cost of health care. This multi-faceted effort also includes the Primary Health Coach program, which provides one coach to coordinate all of a member’s care and help him/her navigate the often confusing health care system; innovative pay-for-performance incentive programs that reward primary care physicians, specialists, and hospitals for providing excellent care and lowering costs; and the Blue Distinction Centers+ program that recognizes hospitals for expertise in quality specialty care and cost-efficiency.
About Independence Blue Cross
Independence Blue Cross is the leading health insurer in southeastern Pennsylvania. With our affiliates, we serve more than 8.2 million people in 24 states and the District of Columbia. For more than 75 years, we have been enhancing the health and wellness of the people and communities we serve by delivering innovative and competitively priced health care products and services; pioneering new ways to reward doctors, hospitals, and other health care professionals for coordinated, quality care; and supporting programs and events that promote wellness. To learn more about how we’re changing the game, visit www.ibx.com. Connect with us on Facebook at ibx.com/facebook and on Twitter at @ibx. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.