INNOVATION PROFILE Colorado's Patient-Centered Medical Home Pilot Met Numerous Obstacles, Yet Saw Results Such As Reduced Hospital Admissions
INNOVATION PROFILE Colorado's Patient-Centered Medical Home Pilot Met Numerous Obstacles, Yet Saw Results Such As Reduced Hospital Admissions
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DOI：
10.1377/hlthaff.2012.0359
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发表时间：
2012-09-01
期刊：
影响因子：
9.7
通讯作者：
Latts, Lisa M.
中科院分区：
文献类型：
--
作者：
Harbrecht, Marjie G.;Latts, Lisa M.
科罗拉多州以患者为中心的多支付医疗之家试点项目于 2009 年 5 月至 2012 年 4 月期间运行，是该国首批自愿多支付医疗之家试点项目之一。六个健康计划、该州的高风险联合承运人以及十六个家庭或内科诊所（约有 100,000 名患者参与）。尽管目前正在进行全面分析，但初步结果显示，该试点项目显着减少了急诊就诊次数，并减少了入院人数，特别是患有多种慢性病的患者。一位付款人报告称，该试点项目的投资回报率为 250%-400%。然而，参与者也遇到了许多障碍。其中：许多诊所向大部分患者提供额外服务，这些患者的雇主赞助的保险计划拒绝支付以患者为中心的医疗之家扩建所需的额外费用。经验表明，创建以患者为中心的医疗之家并使其取得成功需要在多个方面做出坚定的承诺和协作努力。
The Colorado Multipayer Patient-Centered Medical Home Pilot, which ran from May 2009 through April 2012, was one of the first voluntary multipayer medical home pilot projects in the country. Six health plans, the state's high-risk pool carrier, and sixteen family or internal medicine practices with approximately 100,000 patients participated. Although a full analysis is currently under way, preliminary results show that the pilot significantly reduced emergency department visits and also reduced hospital admissions, particularly for patients with multiple chronic conditions. One payer reported a return on its investment of 250-400 percent in the pilot. However, participants also ran into numerous obstacles. Among them: Many practices were left providing extra services to a large fraction of patients whose employer-sponsored insurance plans declined to pay the enhanced fees necessary to cover the cost of the patient-centered medical home expansion. The experience demonstrates that creating patient-centered medical homes and enabling them to be successful will take strong commitments and collaborative efforts on multiple fronts.