Medpage Today
May 30, 2013
The family physician wanted to take the lead on starting a patient-centered medical home (PCMH) model for his 25-physician practice in Frederick, Md., after reading a nearly 100-page treatise from the area's largest private payer.
The program from CareFirst BlueCross BlueShield -- like so many others -- would pay a bonus for spending extra time with their sicker patients. The money would cover a care coordinator nurse to help oversee these patients' care.
That nurse would help identify the practice's most needy patients, help develop a care plan with their physician, and ensure that the patient saw it through.
"That nurse does a lot of work so the physicians don't have to do it," Ashwal told MedPage Today.
The program -- the Total Care and Cost Improvement Program -- has been a game-changer for Ashwal and his practice, Frederick Primary Care Associates, yielding more than a 20% increase in payments from CareFirst last summer for the group's success during 2011 in lowering spending by keeping patients out of the hospital and emergency departments. Read the full article here.
