The cost of care for 1 million consumers in a medical home pilot project was lower than projected for 2012, according to
results that CareFirst BlueCross BlueShield, which serves the Washington metro area, announced May 6.
The second year of test yielded $98 million, or 2.7% in 2012 savings. In 2011, the costs turned out to be 1.5 % lower than anticipated.
Medical home arrangements vary, but one basic is that patients get more attention than usual from their primary care physicians, who oversee all aspects the care provided. Many physician offices assign nurses or other assistants to follow up with patients and make sure they are taking medication as directed, maintaining healthy habits and keeping their scheduled medical appointments.
The goal is to avoid costly hospitalizations and complications by making sure patients get their needs met through routine primary care or cost-effective care from specialists. Compared with CareFirst BlueCross BlueShield enrollees who received conventional coverage, the medical home population had 15% lower inpatient medical costs and 4% lower drug costs. Cost per admission also was 8.3% lower for coordinated care patients, and they were less likely to be admitted or re-admitted to the hospital.
CareFirst CEO Chet Burrell said it’s not clear whether the costs will continue to decline, but he sees chance they will. “There are many more admissions that could be avoided, many more ER visits that can be avoided. We’re not near the potential of what could be done,” he said.